University of Illinois

LCME

Liaison Committee on Medical Education

Goals and Objectives

M2 Goals and Objectives
History, Physical, and Diagnosis (HxPxDx)

COURSE NAME
       
        History, Physical, and Diagnosis (HxPxDx)

Diagnosis, Introduction to Diagnosis:

Lecture Objectives:

  1. The student shall be able to understand the basic framework of thought which should be utilized during patient examinations to begin determining a diagnosis
  2. The student shall understand the definition and usage of: a problem list, a differential diagnosis, and assessment & plan 
  3. The student shall understand the thought processes involved in synthesizing the information obtained from the history and physical exam into a list of medical problems and possible connections between them
  4. The student shall understand the rudiments of the critical thought process involved in building a differential diagnosis from a problem list
  5. The students shall be familiar with the concept of an assessment and plan based on the history and physical exam

    Diagnosis, Patient Presentation:

Lecture Objectives:

  1. The student shall be able to understand the various manners in which patient information may be presented to different audiences
  2. The student shall understand the importance of succinct yet complete presentation of patient information
  3. The student shall understand the importance and role of a complete patient presentation in medical care and medical education
  4. The student shall understand the importance and role of short patient presentation in medical care and medical education
  5. The student shall understand the importance and role of an abbreviated patient presentation in medical care and medical education

History, Introduction:

Lecture Objectives:

  1. The student shall be able to understand the importance of a correct, complete medical history
  2. The student shall be able to understand the correct manner in which a medical history should be obtained
  3. The student shall be able to understand the importance of an empathetic approach to patients

History, General:

Lecture Objectives:

  1. The student shall be able to list the different portions of a medical history and understand in which portion different information belongs
  2. The student shall be able to correctly order the information in a medical history to follow a standard format and communicate that information accurately and succinctly
  3. The student shall be able to understand the various facets of the chief complaint which must be asked during a medical history-taking
  4. The student shall understand how to ask both open-ended and specific questions when appropriate during a medical interview

History, General:

Lecture Objectives:

  1. The student shall be able to understand what information is important enough to belong in the Past Medical History and how to elicit that information
  2. The student shall be able to understand what information is important enough to belong in the Family Medical History and how to elicit that information
  3. The student shall be able to understand what information is important enough to belong in the Social History and how to elicit that information
  4. The student shall understand the importance of the Review of Systems and how to correctly gather that information

History, Sexual History:

Lecture Objectives:

  1. The student shall be able to understand the importance of a correct sexual history
  2. The student shall understand how to elicit a complete sexual history from a patient regardless of that patient’s gender, sexual preference, or practices
  3. The student shall be able to accurately and succinctly report the information gathered from a medical interview concerning the patient’s sexual history

History, Substance Abuse History:

Lecture Objectives:

  1. The student shall be able to understand the importance of a correct Substance Abuse history
  2. The student shall understand the essentials of a correct Substance Abuse history and the correct approach to a patient with a history of substance abuse
  3. The student shall be able to accurately and succinctly report the information gathered from a medical interview concerning the patient’s Substance Abuse history
  4. The student shall understand and utilize the CAGE questions to assess substance dependency
  5. The student shall know the amount of substance utilization which constitutes substance abuse
  6. The student shall be able to differentiate substance use, substance abuse, and substance dependence

    History, OB/Gyn History:

Lecture Objectives:

  1. The student shall be able to understand the importance of a correct OB/Gyn history
  2. The student shall understand the essentials of a correct OB/Gyn history and the general approach to an OB/Gyn patient
  3. The student shall be able to accurately and succinctly report the information gathered from a medical interview concerning the patient’s OB/Gyn history

History, Pediatric Exam:

Lecture Objectives:

  1. The student shall be able to understand the difference between an examination of an adult patient and an examination of a pediatric patient
  2. The student shall understand the essentials of a correct pediatric history and physical examination
  3. The student shall be able to accurately and succinctly report the information gathered from a pediatric examination
  4. The student shall know and understand the Tanner stages of development

History, Hospitalized Patient Exam:

Lecture Objectives:

  1. The student shall be able to understand the difference between an examination of a healthy adult patient and an examination of a hospitalized patient
  2. The student shall understand the essentials of a correct hospitalized patient history and physical exam
  3. The student shall be able to accurately and succinctly report the information gathered from a hospitalized patient examination

History, Practice Lab 1:

Lecture Objectives:

  1. The student shall be able to interview each other eliciting a complete medical history, either the student’s actual history or using a script provided by the Teaching Assistant
  2. The student shall make use of the open-ended and specific questioning techniques presented in lecture
  3. The student shall practice forming an empathic bond with the student playing the “patient”
  4. The student shall be able to accurately and succinctly communicate the information elicited through a complete history write-up

History, Practice Lab 2:

Lecture Objectives:

  1. The student shall be able to interview each other eliciting a complete medical history utilizing the student’s actual history
  2. The student shall make use of the open-ended and specific questioning techniques presented in lecture
  3. The student shall practice forming an empathic bond with the student playing the “patient”
  4. The student shall be able to accurately and succinctly communicate the information elicited through a complete history write-up

History, Introduction to Taped History Practice Sessions:

Lecture Objectives:

  1. The student shall understand the expectations and procedures involved in the video-taped history practice sessions utlizing standardized patients
  2. The student shall understand the purpose of the session which is to provide a “real-world” chance to utilize the skills the student has learned through this course

Physical Exam, Intro to PE:

Lecture Objectives:

  1. The student shall be able to understand the importance of the physical exam
  2. The student shall understand how to correctly and professionally initiate a physical exam with a patient 
  3. The student shall understand how to effectively utilize draping and vocal communication with the patient to maintain patient’s modesty and comfort

Physical Exam, Dermatology:

Lecture Objectives:

  1. The student shall be able to understand the importance of a correct dermatologic physical exam
  2. The student shall understand how to correctly perform a dermatology examination through observation, palpation, and accurate measurement
  3. The student shall understand how to interpret the information gathered through a thorough dermatologic exam
  4. The student shall be able to accurately and succinctly report the information elicited from a dermatologic examination

Physical Exam, Endocrine:

Lecture Objectives:

  1. The student shall be able to understand the importance of a correct endocrine examination, focusing particularly on thymic disorders
  2. The student shall understand how to correctly perform an endocrine exam through observation and palpation
  3. The student shall understand how to interpret the information gathered through a thorough endocrine exam
  4. The student shall be able to accurately and succinctly report the information elicited from an endocrine examination

Physical Exam, Musculoskeletal 1:

Lecture Objectives:

  1. The student shall be able to understand the importance of a correct musculoskeletal physical exam
  2. The student shall understand how to correctly perform a musculoskeletal examination through observation, palpation, and manipulation
  3. The student shall understand how to interpret the information gathered through a thorough musculoskeletal exam
  4. The student shall be able to accurately and succinctly report the information elicited from an musculoskeletal examination

Physical Exam, Musculoskeletal 2:

Lecture Objectives:
            (continuation of 1.10 Physical Exam, Musculoskeletal 1)

  1. The student shall be able to understand the importance of a correct musculoskeletal physical exam
  2. The student shall understand how to correctly perform a musculoskeletal examination through observation, palpation, and manipulation
  3. The student shall understand how to interpret the information gathered through a thorough musculoskeletal exam
  4. The student shall be able to accurately and succinctly report the information elicited from an musculoskeletal examination

Physical Exam, Male Genital/Rectal:

Lecture Objectives:

  1. The student shall be able to ask history questions pertinent to the male genital and rectal exam.
  2. The student shall understand how to correctly perform a male genital and rectal exam through observation, palpation, and manipulation, as well as associated testing.
  3. The student shall understand how to interpret the information gathered through a thorough male genital and rectal exam
  4. The student shall be able to accurately and succinctly report the information elicited from a male genital and rectal examination.
  5. The student shall be able to discuss the applicability of preventative medicine recommendations in association with the male genital-rectal exam.
  6. The student shall be able to distinguish abnormalities associated with the male genital-rectal exam, including but not limited to:
Cryptordism, hypospadias, balanitis, phimosis, paraphimosis, varicocele, hydrocele, epididymitis, orchitis, testicular cancer, herpes, genital warts, syphilic chancre, internal and external hemorrhoids, anal fissure, anal warts, anal prolapse, rectal cancer, pilonidal cyst, testicular torsion, prostatitis, and prostate cancer

Physical Exam, Female Exam Intro:

Lecture Objectives:

  1. The student shall be able to understand the importance of a correct pelvic and breast physical exam
  2. The student shall understand how to correctly perform a pelvic and breast examination using observation, palpation, speculum examination, and bimanual examination
  3. The student shall understand how to interpret the information gathered through a thorough pelvic and breast exam
  4. The student shall be able to accurately and succinctly report the information elicited from a pelvic and breast examination

Physical Exam, General Review:

Lecture Objectives:

  1. The student shall be able to correctly sequence the different portions of the physical examination to minimize transition time and smooth the process of the physical examination
  2. The student shall recall the diverse portions of the physical examination and have an opportunity to ask any questions regarding the performance of the exam or procedural questions for sequencing the diverse portions

Physical Exam, Cardiology:

Lecture Objectives:

  1. The student shall be able to understand the importance of a correct cardiac physical exam
  2. The student shall understand how to correctly perform a cardiac examination through observation, palpation, and auscultation
  3. The student shall understand how to interpret the information gathered through a thorough cardiac exam
  4. The student shall be able to accurately and succinctly report the information elicited from a cardiac examination

Physical Exam, Respiratory:

Lecture Objectives:

  1. The student shall be able to understand the importance of a correct pulmonary physical exam
  2. The student shall understand how to correctly perform a pulmonary examination through observation, palpation, percussion, and auscultation
  3. The student shall understand how to interpret the information gathered through a thorough pulmonary exam
  4. The student shall be able to accurately and succinctly report the information elicited from a pulmonary examination

Physical Exam, Abdominal:

Lecture Objectives:

  1. The student shall be able to understand the importance of a correct abdominal physical exam
  2. The student shall understand how to correctly perform a abdominal examination through observation, palpation, percussion, and oscultation
  3. The student shall understand how to interpret the information gathered through a thorough abdominal exam
  4. The student shall be able to accurately and succinctly report the information elicited from an abdominal examination

Physical Exam, Peripheral Vascular:

Lecture Objectives:

  1. The student shall be able to understand the importance of a correct peripheral vascular exam
  2. The student shall understand how to correctly perform a peripheral vascular examination through observation and palpation
  3. The student shall understand how to interpret the information gathered through a thorough peripheral vascular exam
  4. The student shall be able to accurately and succinctly report the information elicited from a peripheral vascular examination

Physical Exam, Eye, Ear, and Nose:

Lecture Objectives:

  1. The student shall be able to understand the importance of a correct Eye, Ear, and Nose physical exam
  2. The student shall understand how to correctly perform an Eye, Ear, and Nose examination through observation and palpation, using the otoscope, tuning forks, penlight, and eye chart
  3. The student shall understand how to interpret the information gathered through a thorough Eye, Ear, and Nose exam
  4. The student shall be able to accurately and succinctly report the information elicited from an Eye, Ear, and Nose examination

Physical Exam, Opthalmoscope:

Lecture Objectives:

  1. The student shall be able to understand the importance of a correct opthalmologic examination
  2. The student shall understand how to correctly perform eye examination using an opthalmoscope; including correct equipment usage and correct technique.
  3. The student shall understand how to interpret the information gathered through an opthalmologic examination; including evaluation of the sclera, anterior chamber, lens, vitreous chamber, retinal blood vessels, and fundus
  4. The student shall be able to accurately and succinctly report the information elicited from an opthalmologic examination using correct terminology

Physical Exam, Oral and Dental:

Lecture Objectives:

  1. The student shall be able to understand the importance of a correct oral and dental examination
  2. The student shall understand how to correctly perform an oral and dental exam through observation and palpation
  3. The student shall understand how to interpret the information gathered through a thorough oral and dental exam
  4. The student shall be able to accurately and succinctly report the information elicited from an oral and dental examination

Physical Exam, Neurologic:

Lecture Objectives:

  1. The student shall be able to understand the importance of a correct neurologic physical exam
  2. The student shall understand how to correctly perform a neurologic examination through observation and palpation, using the tuning fork, microfilament, reflex hammer, and penlight
  3. The student shall understand how to interpret the information gathered through a thorough neurologic exam
  4. The student shall be able to accurately and succinctly report the information elicited from an neurologic examination

Physical Exam, Intro to PE:

Lecture Objectives:

  1. The student shall be able to correctly initiate a physical examination with a fellow student, including use of correct language and maintenance of a professional environment
  2. The student shall be able to demonstrate correct use of draping and examination table features to maintain patient modesty and comfort
  3. The student shall be able to observe correct hygenic practices during a physical examination, protecting both the patient and the examiner
  4. The student shall be able to initiate physical contact with the patient in an appropriate and comfortable manner

Physical Exam, Skin Exam:

Lecture Objectives:

  1. The student shall be able to correctly perform a comprehensive examination of the skin, hair, and nails of a fellow student in a professional and expedient manner
  2. The student shall be able to demonstrate correct description (including location, measurements, color, elevation, etc.) of any notable features found during the skin, hair, and nails examination
  3. The student shall be able to differentiate between normal and abnormal findings on the skin, hair, and nails examination
  4. The student shall be able to correctly document the findings of their skin examination, using accurate terminology and specific descriptions

Physical Exam, Cardiac Exam:

Lecture Objectives:

  1. The student shall be able to correctly perform a comprehensive physical examination of the cardiac system of a fellow student
  2. The student shall be able to demonstrate correct inspection, palpation, and auscultation to assess cardiac function
  3. The student shall be able to differentiate the normal sounds of the cardiac system and identify S1, S2, systolic vs. diastolic timing at the 5 primary points of auscultation on the chest and at the carotids
  4. The student shall be able to correctly demonstrate techniques to accentuate cardiac murmurs preferentially based on the valve involved including: valsalva, auscultation in the left-lateral-decubitus, squatting, and auscultation during deep respiration
  5. The student shall be able to correctly document the findings of their cardiac examination, using accurate terminology and timing diagrams

Physical Exam, Neurologic Exam:

Lecture Objectives:

  1. The student shall be able to correctly perform a comprehensive physical examination of the Neurologic system of a fellow student
  2. The student shall be able to demonstrate correct evaluation of the neurologic function including: cranial nerves, deep tendon reflexes, cerebellar function, sensation (light touch, pain, vibration, position), vestibular function, and gait 
  3. The student shall be able to idnetify normal findings of the neurologic examination
  4. The student shall be able to correctly document the findings of their neurologic examination, using accurate terminology

Physical Exam, Musculoskeletal Exam:

Lecture Objectives:

  1. The student shall be able to correctly perform a comprehensive physical examination of the musculoskeletal system of a fellow student
  2. The student shall be able to demonstrate correct evaluation of the musculoskeletal function including: range of motion, muscular strength, alignment, and joint abnormalities at the shoulder, elbow, wrist, fingers, hips, knees, ankles, and spine  
  3. The student shall be able to idnetify normal findings of the musculoskeletal examination
  4. The student shall be able to correctly document the findings of their musculoskeletal examination, using accurate terminology

Physical Exam, Male Genito-Rectal Exam:

Lecture Objectives:

  1. The student shall be able to correctly perform a comprehensive physical examination of the genital and rectal areas of a practical instructor
  2. The student shall be able to demonstrate correct evaluation using inspection and palpation of the genito-rectal areas including: inspection for skin lesions, urethral secretions, assessment for hernias, evaluation of the testes and epididimis, palpation of the spermatic cord, palpation of the anal sphincter muscles, and evaluation of the rectum and prostate
  3. The student shall be able to identify normal and abnormal findings of the male genito-rectal examination
  4. The student shall be able to correctly document the findings of their male genito-rectal examination, using accurate terminology

Physical Exam, Female Breast and Genital Exam:

Lecture Objectives:

  1. The student shall be able to correctly perform a comprehensive physical examination of the breast and genital areas of a practical instructor
  2. The student shall be able to demonstrate correct evaluation using inspection and palpation of the breast and genital areas including: inspection for skin lesions or retractions, palpation for inconsistencies in breast tissue texture, assessment for lymphadenopathy (both axillary and inguinal), evaluation of the vulva and vagina,  evaluation of the uterus and adnexal structures, and palpation of the vagino-rectal wall
  3. The student shall be able to identify normal and abnormal findings of the female breast and genital examination
  4. The student shall be able to correctly document the findings of their female breast and rectal examination, using accurate terminology
  5. The student shall be able to instruct a patient on how to perform her own breast examination at home utilizing a sensitive manner and terminology

Physical Exam, Sequencing the Physical Exam:

Lecture Objectives:

  1. The student shall be able to correctly perform a comprehensive physical examination of a fellow student excluding the breast and genito-rectal exam
  2. The student shall be able to sequence the physical examination to maximize time utilization and minimize: changing of the patient’s position, changing of instruments, changing between systems examined
  3. The student shall be able to correctly perform the examination to obtain all the necessary information in the minimum amount of time without sacrificing the patient-physician interaction
  4. The student shall be able to correctly document the findings of their complete physical examination, using accurate terminology

Physical Exam, Heart Sounds Lab:

Lecture Objectives:

  1. The student shall be able to correctly identify normal cardiac sounds and rhythms as presented through a digital simulation
  2. The student shall be able to correctly identify abnormal cardiac sounds and rhythms as presented through a digital simulation
  3. The student shall be able to correctly document normal and abnormal cardiac sounds and rhythms using accurate terminology and timing diagrams

Physical Exam, Heart Murmur Lab:

Lecture Objectives:

  1. The student shall be able to perform a correct and thorough cardiac exam on a standardized patient, while observing correct physician-patient interaction (e.g. proper draping, proper form of address)
  2. The student shall be able to correctly identify abnormal heart sounds, rate, and rhythm on a standardized patient with a stable cardiac finding
  3. The student shall be able to synthesize their findings to a reasonable differential of possible causes of the abnormal cardiac findings
  4. The student shall be able to correctly document the findings of their cardiac examinations, including timing diagrams and correct terminology

Physical Exam, Pulmonary Exam:

Lecture Objectives:

  1. The student shall be able to correctly perform a comprehensive physical examination of the pulmonary system of a fellow student
  2. The student shall be able to demonstrate correct inspection, palpation, percussion, and auscultation to assess pulmonary function
  3. The student shall be able to differentiate the normal findings of the pulmonic system examination through inspection, palpation, percussion, and auscultation on both the anterior and posterior chest
  4. The student shall be able to correctly document the findings of their pulmonary examination, using accurate terminology

Physical Exam, Abdominal Exam:

Lecture Objectives:

  1. The student shall be able to correctly perform a comprehensive physical examination of the abdomen of a fellow student
  2. The student shall be able to demonstrate correct inspection, auscultation,  percussion, and palpation to assess abdominal status
  3. The student shall be able to differentiate the normal findings of the abdominal system examination through inspection, palpation, percussion, and auscultation
  4. The student shall be able to demonstrate the correct techniques to assess: liver size, spleen size, presence of ascites, rebound tenderness, gall bladder inflammation, and peritoneal or muscular inflammation within the abdomen
  5. The student shall be able to correctly document the findings of their abdominal examination, using accurate terminology

Physical Exam, Peripheral Vascular Exam:

Lecture Objectives:

  1. The student shall be able to correctly perform a comprehensive physical examination of the peripheral vasculature of a fellow student
  2. The student shall be able to demonstrate correct inspection and palpation to assess peripheral vascular function
  3. The student shall be able to differentiate the normal findings of the peripheral vascular examination through inspection and palpation
  4. The student shall be able to demonstrate the correct techniques to assess: peripheral pulses at the carotid, brachial, radial, femoral, popliteal, dorsalis pedis, and posterior tibial points; capillary reperfusion time; and signs of peripheral vascular insufficiency (arterial or venous)
  5. The student shall be able to correctly document the findings of their peripheral vascular examination, using accurate terminology

Physical Exam, Eye, Ear, and Nose Exam:

Lecture Objectives:
  1. The student shall be able to correctly perform a comprehensive physical examination of the eye, ear, and nose of a fellow student
  2. The student shall be able to demonstrate correct inspection and palpation to assess eye, ear, and nose function using tuning forks, a penlight, and an otoscope
  3. The student shall be able to differentiate the normal findings of the eye, ear, and nose examination through inspection and palpation, and use of the appropriate tools
  4. The student shall be able to demonstrate the correct techniques to assess: gross hearing, determination of laterality to hearing loss, determination of conduction vs nervous defect in hearing loss, health of the tympanic membrane and associated structures, visual acuity, gross visual field deficits, oculomotor deficits, nare patency, health of the nasal mucosa
  5. The student shall be able to correctly document the findings of their eye, ear, and nose examination, using accurate terminology

Physical Exam, Oral and Dental Exam:

Lecture Objectives:

  1. The student shall be able to correctly perform a comprehensive physical examination of the jaw and oral cavity of a fellow student
  2. The student shall be able to demonstrate correct inspection and palpation to assess the oral mucosa, tongue, teeth, gingiva, lips, salivary glands, jaw, and temporal-mandibular joint function
  3. The student shall be able to differentiate the normal findings of the oral and dental examination through inspection and palpation
  4. The student shall be able to demonstrate the correct techniques to assess: TMJ function, health of the various oral and dental components
  5. The student shall be able to correctly document the findings of their oral and dental examination, using accurate terminology

 

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