How to Study Physical Diagnosis

Physical Diagnosis is the study and clinical evaluation of a patient for signs and symptoms of disease. It usually involves a medical interview and history followed by a full physical exam that investigates all systems of the human body. Most courses include two exams, one multiple-choice written exam and one live physical exam on a standardized patient. Try the following study strategies and tips to help you learn how to study Physical Diagnosis.

Study Tip #1 - Do not procrastinate.

Most students initially write off the material as a memorizable list of questions to ask and simple exam techniques. While some of this may be true, waiting until the last minute will lead to a robotic and disengaged clinical interaction as the student reads off their list. Start early and put in the effort to implement some of the study tips below.

Study Tip #2 - Remember your manners.

This is a very important tip because it sets the tone of the interview and physical exam from the beginning. Always knock before entering a room and greet the patient as Mr. or Mrs. ______. You should always read their name from the chart before entering the room. However, do not make any assumptions about gender or race based on the name. Names like "Kelly" and "Danny" are often used by both genders. Don't forget to shake the patient's hand and thank them once the exam is complete.

Study Tip #3 - Keep it professional.

The first impression will be your appearance. Gentlemen should be clean-cut and sport a tie and slacks. Women should dress conservatively without open-toe shoes and keep dresses and skirts to an appropriate length. The next impression will stem from your mannerisms. Carry yourself with confidence and speak with sincerity and empathy.

Study Tip #4 - Talk through the physical exam.

This creates a fluid interaction and makes the patient feel more comfortable as you are going through the steps. Say things like, "Okay, now I'm going to examine your stomach if you could please lay down?" versus "Please lay down on the table."; or just moving your hands over the patients midsection without warning. This provides some structure to the exam and allows the patient to participate and exercise some aspect of control.

Study Tip #5 - Make sure the patient is comfortable.

Take note of their body language and adjust your exam if needed. This may be as simple as offering the patient a glass of water after examining their throat, tissue if they have a runny nose, or putting their socks back on after a foot exam. For example, if a patient is complaining of a throbbing migraine, you may offer to dim the lights. These small gestures improve the doctor-patient relationship and increase the quality of care.

Study Tip #6 - Be very descriptive.

Every single finding, whether abnormal or appropriate on the physical exam is important. You must be descriptive so that other people may derive the intended meaning from your notes simply by reading them without the patient present. Use words to explain the shape, duration, color, intensity, direction, and texture of your findings. Try to avoid the word "Normal" in your description because there is a wide range of normal responses for people. Use words like appropriate, symmetrical, equal, well-developed, and others that explain your findings.

Study Tip #7 - Be thorough.

Bates' Guide to Physical Examination and History Taking