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Am J Med Sci. 2014 Mar;347(3):199-205. doi: 10.1097/MAJ.0b013e3182831798.

Evaluation of an advanced physical diagnosis course using consumer preferences methods: the nominal group technique.

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  • 1School of Medicine (JC), University of Alabama at Birmingham, Birmingham, Alabama; Department of Medicine, University of Central Florida School of Medicine (AC), Orlando, Florida; and Division of General Internal Medicine (RRK, FSM, JLM, SWR, TS, LLW, CAE), Tinsley Harrison Internal Medicine Residency Program (RRK, JLM, LLW), Division of Infectious Diseases (MR), Tinsley Harrison Medical Service (MR), Moody Clinic (SWR), Division of General Pediatrics (SWR), Birmingham Veterans Affairs Medical Center (TS, CAE, RRK, SFM, JLM), and Veterans Affairs National Quality Scholars Program (CAE), Birmingham Veterans Affairs Medical Center, University of Alabama at Birmingham, Birmingham, Alabama.



Current evaluation tools of medical school courses are limited by the scope of questions asked and may not fully engage the student to think on areas to improve. The authors sought to explore whether a technique to study consumer preferences would elicit specific and prioritized information for course evaluation from medical students.


Using the nominal group technique (4 sessions), 12 senior medical students prioritized and weighed expectations and topics learned in a 100-hour advanced physical diagnosis course (4-week course; February 2012). Students weighted their top 3 responses (top = 3, middle = 2 and bottom = 1).


Before the course, 12 students identified 23 topics they expected to learn; the top 3 were review sensitivity/specificity and high-yield techniques (percentage of total weight, 18.5%), improving diagnosis (13.8%) and reinforce usual and less well-known techniques (13.8%). After the course, students generated 22 topics learned; the top 3 were practice and reinforce advanced maneuvers (25.4%), gaining confidence (22.5%) and learn the evidence (16.9%). The authors observed no differences in the priority of responses before and after the course (P = 0.07).


In a physical diagnosis course, medical students elicited specific and prioritized information using the nominal group technique. The course met student expectations regarding education of the evidence-based physical examination, building skills and confidence on the proper techniques and maneuvers and experiential learning. The novel use for curriculum evaluation may be used to evaluate other courses-especially comprehensive and multicomponent courses.

[PubMed - indexed for MEDLINE]
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