FACTORS INFLUENCING CARDIOVASCULAR EXAMINATION PERFORMANCE BY MEDICAL STUDENTS

There has been a recent renewed interest in physical examination (PE) skills among medical trainees. While many studies focus on the ability of trainees to interpret findings, few have actually addressed PE techniques and factors that influence PE performance. The purpose of this study was to explore potential factors influencing the technique of the cardiovascular PE by medical students. Fourth year medical students (n=184) were observed during a clinical skills assessment exercise with standardized patients (n=368). Using logistic regression, the researcher investigated the association between two variables and the completeness of the cardiac exam: the patient’s position (supine or sitting) and patient gender. Complete heart examination was conducted in 52.5% of encounters, which was less often performed on female patients (p=0.005); female students more frequently conducted a complete examination (p<0.05). The analysis also demonstrated that patient position (supine or mixed supine and sitting compared to sitting only) influenced completeness of exam (p<0.001). The current study showed that nearly half of the patients did not have a complete heart examination. The gender of both the patient and the student and the position of the examiner during the exam appeared to have an impact on PE technique. Findings support the need for closer attention to PE techniques during medical training. The utilization of tools and techniques such as Web 2.0 tools could improve the standard cardiovascular examination.