Critical Synthesis Package: Hypothesis-Driven Physical Examination (HDPE)

Abstract

Abstract This Critical Synthesis Package contains: (1) a Critical Analysis of the psychometric properties and application to health sciences education for the Hypothesis-Driven Physical Examination (HDPE), (2) a copy of the HDPE faculty handbook, a copy HDPE student handbook, and an example of HDPE scoring developed by Rachel Yudkowsky, MD. The HDPE is a method for assessing both students' physical exam skills and their diagnostic reasoning around the physical exam. Students are given two competing diagnoses and asked to list anticipated physical signs, perform the exam on a specially-trained patient instructor (PI), receive feedback from the PI, and revise their exam and working diagnosis. The HDPE is well grounded in educational theory, may be used to supplement the survey approach to teaching the physical exam (e.g., a “head-to-toe” approach), and may be most appropriate for students who already have a basic knowledge of the physical exam. The HDPE is not yet widely implemented but has been adapted for use by several medical schools for both teaching and assessment. There has been only one small study comparing a hypothesis-driven approach to a standard approach to the physical exam. More research is needed to know whether diagnostic accuracy and/or exam technique are improved with the HDPE.

Keywords

• Physical Examination
• Educational Measurement
• Clinical Competence
• DREAM
• Directory and Repository of Educational Assessment Measures
• Clinical Skills Assessment