CLSK 653 Communication Skills and Physical Diagnosis

The Communication Skills and Physical Diagnosis course consists of approximately 227 scheduled class hours where the students are expected to learn the art of skilled interviewing and the skills of physical examination. Students are taught history taking in the broad sense. History taking consists of the “what” (information obtained from the patient encounter) and the “how” (techniques of communication skills) to obtain the maximum amount of information while being empathetic, considerate and paying attention to the patient’s feelings and rights. Physical diagnosis is taught in the lab and the student is taught how to utilize the senses of sight (observation), touch (palpation and percussion) and hearing (auscultation) as a unified exercise. Both history taking and physical diagnosis are taught in the lab in small groups.

Physical Diagnosis is taught along system lines: Although this teaching is sectionalized, one must realize that the patient must be approached as a unit with all systems functioning in an integrated manner.

Small Groups

With the guidance of clinical tutors and full-time faculty, small groups of no more than eight students per group have the opportunity to learn the initial steps of physical examination, such as inspection, percussion, auscultation, and so forth, through a problem-based environment. In addition, relevant core clinical cases are presented to the students in order to facilitate basic interpretation of professional competencies and team-based interpersonal skills.

Student Assessment

Consists of three written examinations—one unified, one midterm written, and one final written; three quizzes and one OSCE. All examinations cover topics discussed in lectures and labs. Of the three quizzes, one consists of a case write-up obtained from evaluation of an actual “patient.” The OSCE is a lab-based practical examination covering patient’s interview and physical examination.

Term 4 is a departure from the students’ experiences in Terms 1, 2 and 3. These terms deal with Basic Science and rely heavily on memorization and recall. Although Clinical Skills require a strong foundation in Basic Sciences, it deals mainly with the application of knowledge. Term 4 provides the first real experience for the medical student to interview patients, real or simulated, and to examine fellow medical students, simulated patients, and real patients. To students, this is the real beginning of medicine.

Vertical integration of all aspects of lessons taught throughout the medical school is essential. Students must recognize that courses taught in Basic Science are needed for the understanding of Clinical Skills.