Context and setting Medical school physical examination (PE) education focuses on the acquisition of skills in three domains: psychomotor (motor skills); affective (interaction with examinees), and cognitive (interpretation). To reinforce learning in the cognitive domain, we currently offer an advanced physical diagnosis elective to senior medical students to teach the principles of evidence-based physical examination (EBPE). Why the idea was necessary Recent studies have emphasised a 'syntiietic' domain: practising doctors must not only recognise findings and understand their evidence-based utility, but must also make optimal management decisions based on these findings. 'Synthesis' is rarely taught; rather, students are expected to become adept simply with experience. Consequently, as they make the transition to internship, students may be ill-prepared to apply EBPE in practice.
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