Following a "performance," the standardized patients complete a physician evaluation form. Below is a sample physical evaluation form.
Process
( ) Yes ( ) No Wash hands
( ) Yes ( ) No Note general appearance
( ) Yes ( ) No Pay attention to patient's comfort
Cardiovascular Exam
( ) Yes ( ) No Inspect neck veins
( ) Yes ( ) No Palpate carotid pulse
( ) Yes ( ) No Auscultate carotid artery
( ) Yes ( ) No Inspect and examine chest with patient supine
( ) Yes ( ) No Feel for PMI below nipple
( ) Yes ( ) No Use both diaphragm and bell of stethoscope
( ) Yes ( ) No Listen to apex (mitral value)
( ) Yes ( ) No Listen to left lower sternal border (tricuspid valve)
( ) Yes ( ) No Listen to left second intercostal space (pulmonary valve)
( ) Yes ( ) No Listen to right second intercostal space (aortic valve)
( ) Yes ( ) No Listen to first and second heart sounds
( ) Yes ( ) No Listen for physiological split second sound (pulmonic area)
( ) Yes ( ) No Inspect skin
( ) Yes ( ) No Inspect nail beds
( ) Yes ( ) No Palpate peripheral pulses
( ) Yes ( ) No Palpate for pedal edema
Vital Signs
( ) Yes ( ) No Place cuff on arm, tubing forward over brachial artery
( ) Yes ( ) No Support patient's arm so it is relaxed
( ) Yes ( ) No Measure patient BP
( ) Yes ( ) No Check radial pulse at least 15 seconds
( ) Yes ( ) No Check respiratory rate at least 15 seconds
Lung Exam
( ) Yes ( ) No Stand on right side of patient
( ) Yes ( ) No Assess rate and rhythm of respiration
( ) Yes ( ) No Examine symmetry of chest excursion
( ) Yes ( ) No Percuss alternate sides of lung fields (bilaterally at 3 levels)
( ) Yes ( ) No Auscultate alternate sides of posterior lung fields (bilaterally at 3 levels)
( ) Yes ( ) No Auscultate alternate sides of anterior lung fields (bilaterally at 3 levels)
Global Assessment
Overall, how satisfied were you with this student’s physical examination skills?
( ) extremely dissatisfied
( ) very dissatisfied
( ) dissatisfied
( ) satisfied
( ) very satisfied
( ) extremely satisfied