Getting Physical: The Hypothesis Driven Physical Exam.

DOI: 10.1542/peds.2015-4511 Accepted for publication Dec 14, 2015 Address correspondence to Michael A. Barone, MD, MPH, Johns Hopkins University School of Medicine, Charlotte Bloomberg Children’s Hospital, 1800 Orleans St, Suite 8442, Baltimore, MD 21287. E-mail: [email protected] PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 10984275). Copyright © 2016 by the American Academy of Pediatrics FINANCIAL DISCLOSURE: The authors have indicated they have no fi nancial relationships relevant to this article to disclose. FUNDING: No external funding. POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential confl icts of interest to disclose. The value of teaching at the patient’s bedside has been recognized by generations of clinical teachers and students. In today’s complex and fast-paced medical environment, clinical instructors teach at the bedside less frequently than in the past.1,2 When learning the physical examination, medical students are often taught a series of 100+ anatomy-focused maneuvers.3 The “head-to-toe” approach can help students practice complex maneuvers and develop an awareness of normal findings, but it has limitations in emphasizing the diagnostic relevance of the physical examination.4 Teachers should guide students to transition from a head-to-toe physical examination to one used to support or refute potential diagnoses.