Improving physical exam & investigative skills?

[sirscrubsalot]

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I looked at a few threads concerning the topic, but many are from a while back. There seems to be fairly new editions since the past posts.

Even after passing Step 2 CS & 1, I really feel like I'm blindly doing many physical exam techniques and even more so... lacking better investigative skills to understand why and what I am looking for and doing....

I'm great at asking the initial questions, establishing rapport with the patients, and getting them comfortable for me to examine them... but I myself feel uncomfortable most of the time when doing the focused or general exam on them... frankly because at many times, I'm not sure what I am looking for 🙄

At least for CS there was a general order and you could "wing" most of it, so that totally doesn't count and that was it - no SP's anymore 🙂

I've never owned any physical exam books like bates for example, so I'm not sure if I should go back to that or something else.

I've seen some praises on both degowin's and sapira here but it seems that sapira's might be too advanced for me or is this what I need? I'm not looking to cut corners here - I'd just like to understand more with confidence what I am doing... and hopefully understand more of what I should look for with explanations as to why these might be the best differentials for a given situation.... not too sure on swartz/mosby's either as those were frequently mentioned too...

I'd like to avoid something with nothing but lists and tables with no substance behind it to back it up.

Doing the actual exam techniques, I can improve by doing more in practice @ the clinic and reviewing all the online phys/exam video websites...

Bottom line : something w/o endless tables and lists that have no substance to back them up - need to solidify and improve my theory on this whole because I don't want to half-ass it for all the years to come. I'd like to give my H&P's back to the docs with better confidence rather than vague generalities... All these books are $$$ too - mixed bag of reviews on amazon for most and I can't buy them all 😛

Since I never owned one of these books, will your suggestions include child&adult and anything else?

Thanks a bunch!

 

[cpants]

To be honest, I don't think a book will help that much. Learn the basic exam cold, and then practice, practice, practice. Do a thorough exam on all patients while you are starting out. The key is that if you think or even suspect that you have found something abnormal, get someone more experienced to confirm. Then you will know if you were right or wrong, and recognize the finding in future patients.

 

[Bike on a Trek]

Since you've already had some exposure, I'd suggest

Bates/Swartz/Degowin (you choose for the basics. Degowin is a little more advanced) + JAMA Rational Clinical Examination (for the meatier what is the evidence) + practice

 

[Substance]

Talley and O'Connor Guide to Physical Examination and History Taking.

 

[McGillGrad]

You have to get back to the basic sciences of the physical exam to really understand it and retain it for the long run. Otherwise, it becomes a meaningless routine.

 

[jtlc2345]

Practice is all well and good but you need someone watching you so that you get feedback on what you are doing. Also, I find spending some time just observing colleagues can make you better appreciate your strengths and weaknesses.

Jonathan

 

[sirscrubsalot]

Thanks so much for all the replies and insight! I'll surely keep these rolling in my mind - helped a lot! 😎

 

[sprinkibrio]

How many lightbulbs do you have in your house? I'm intrigued. Why? Socioeconomic status? In the US we can just kind of tell by hygiene, dress, and accent.