A Blended Curriculum to Improve Resident Physical Exam Skills for Patients With Neuromuscular Disability
Jennifer C. Benjamin,
Judith Groner,
Jennifer Walton,
Garey Noritz,
Gregg M. Gascon,
John D. Mahan
Affiliations
Jennifer C. Benjamin
1 Assistant Professor, Department of Pediatrics, Baylor College of Medicine; Assistant Professor, Department of Pediatrics, Texas Children's Hospital
Judith Groner
2 Academic Pediatrics Fellowship Director, Ohio State University College of Medicine; Clinical Professor of Pediatrics, Division of Ambulatory Pediatrics, Nationwide Children's Hospital; Clinical Professor of Pediatrics, Division of Ambulatory Pediatrics, Ohio State University College of Medicine
Jennifer Walton
3 Co-Director, Williams Syndrome Program, Nationwide Children's Hospital; Co-Director, Williams Syndrome Program, Ohio State University College of Medicine; DBP Resident Rotation Director, Nationwide Children's Hospital; DBP Resident Rotation Director, Ohio State University College of Medicine; Assistant Professor of Clinical Pediatrics, Department of Developmental and Behavioral Pediatrics, Nationwide Children's Hospital; Assistant Professor of Clinical Pediatrics, Department of Developmental and Behavioral Pediatrics, Ohio State University College of Medicine
Garey Noritz
4 Medical Director, Complex Health Care Program, Nationwide Children's Hospital; Medical Director, Complex Health Care Program, Ohio State University College of Medicine; Medical Director, Cerebral Palsy Program, Nationwide Children's Hospital; Medical Director, Cerebral Palsy Program, Ohio State University College of Medicine; Associate Professor, Department of Developmental and Behavioral Pediatrics, Nationwide Children's Hospital; Associate Professor, Department of Developmental and Behavioral Pediatrics, Ohio State University College of Medicine
Gregg M. Gascon
5 Advanced Analytics Consultant, Ohio State University Health Plan; Assistant Professor of Biomedical Informatics, Ohio State University College of Medicine
John D. Mahan
6 Associate Director, Center for Faculty Advancement, Mentoring and Engagement (FAME), Ohio State University College of Medicine; Professor, Department of Pediatrics, Ohio State University College of Medicine; Program Director, Pediatric Residency Fellowship Program, Nationwide Children's Hospital; Program Director, Pediatric Residency Fellowship Program, Ohio State University College of Medicine; Program Director, Pediatric Nephrology Fellowship Program, Nationwide Children's Hospital; Program Director, Pediatric Nephrology Fellowship Program, Ohio State University College of Medicine
Introduction Children with neuromuscular disabilities (NMD) receive care in a wide variety of clinical settings. Residents lack training to develop physical examination skills for evaluating patients with NMD. We devised a curriculum to teach residents how to examine patients with NMD using a systematic and simplified approach. Methods Creation of this resource was a response to a survey of final-year residents that revealed the need for education focused on developing physical examination skills. The curriculum has four components—multimedia PowerPoint with embedded video, knowledge assessment, clinical exam (CEX) assessment, and module feedback—and was completed by 37 residents over an 8-month period from January to September 2016. We utilized knowledge assessment, direct clinical skills observation using the CEX, and module-feedback responses as part of the evaluation. Results All 37 residents completed the curriculum, with an overall knowledge score of greater than 80%. Residents demonstrated most of the desired patient care behaviors on the CEX assessment and provided positive feedback on the quality, usefulness, and applicability of the module, in addition to requesting more curricula to develop their physical examination skills. Discussion The CEX assessment provided a unique opportunity for faculty feedback on residents’ physical exam performance. After completing the module, residents achieved high scores in most areas of the standardized CEX and were able to conduct the NMD physical exam in a sensitive manner. The assessment highlighted the need to improve residents’ skills of detecting abnormal clinical findings and communicating with the patient during the physical exam.
