Development of the periodic review of systems: bridging the annual history and physical examinations
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AbstractWithin the clinical interview, the general review of systems has four main objectives: to evaluate the past and present health of each body system, to double check for omitted patient information from the present illness, to promote healthy living and offer patient education. Medical students have difficulty learning this interview section through its focused use of questions that could relate to a multitude of possible medical symptoms. Educators strive to assist students organize their knowledge and enhance their communication skills. The quality of patient data is related to the type of questions that are asked. The PROS concept was created as fourteen different questions, with clinical content validated by the medical literature, that review major medical diseases and their illness effects, blending medical and patient centered approaches. This research tested the feasibility and reliability of the PROS instrument with first year medical students who used this format as part of their clinical interview with simulated patients (SPs) at the University of Calgary. Data collection occurred through videotaped student interviews that involved nine different medical case scenarios. The evaluation assessed the completeness of questions, the scope of added clinical content, the performance time and the understanding ability of SPs to correctly answer the PROS questions based upon their clinical scripts. Results were favorable on these four measures, supporting the PROS as a valuable clinical instrument. Its potential application towards teaching medical trainees, implementation into clinical practice, and proposed future research suggest worthwhile promise for furthering its development.
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