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Physical Examination

Physical Examination

Physical Examination

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CHECKLIST FOR STANDARDIZED PATIENTS TO COMPLETE FOLLOWING<br />

PHYSICAL EXAMINATION<br />

Checklist item Technique standard to be observed Yes No<br />

1. Wash hands The student washed his/her hands<br />

before the exam.<br />

2. Determine BP The collapsed blood pressure cuff was<br />

placed snugly and smoothly around my<br />

bare arm, so that the lower edge of<br />

the cuff was at least 1 inch above<br />

my antecubital fossa.<br />

3. After inflating the blood pressure cuff,<br />

the student let the cuff deflate slowly<br />

while listening with his/her stethoscope<br />

over the artery in my antecubital fossa.<br />

4. The student informed me of my BP.<br />

5. Examine eyes. I was asked to read the letters on a<br />

card (or newsprint) held 14 inches<br />

away, first with one eye covered, then<br />

with the other eye covered. I was<br />

tested with and without my glasses.<br />

6. I was asked to follow the student’s<br />

finger to the extreme of upper outer<br />

gaze and lower outer gaze for both<br />

eyes.<br />

7. I was asked to stare at the student’s<br />

finger as he/she moved it from a<br />

distance toward my nose.<br />

8. I was instructed to stare at a distant<br />

object while the student examined my<br />

eyes with the ophthalmoscope.<br />

9. The student held the ophthalmoscope<br />

2.5-3 inches away from my eye in order<br />

to examine my retina.<br />

10. With the ophthalmoscope, the student<br />

used his/her right eye to examine my<br />

right eye and his/her left eye to<br />

examine my left eye.<br />

11. Examine ears. The student pulled my ear gently up<br />

and backwards as he/she placed the<br />

otoscope in my ear.<br />

12. The insertion of the otoscope in my<br />

ears was not painful.<br />

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13. Examine mouth. The student looked at the sides and<br />

under my tongue.<br />

14. The student asked me to say “ah”.<br />

15. Examine neck<br />

for lymph<br />

nodes.<br />

16. Examine carotid<br />

arteries.<br />

The student palpated the back and<br />

sides of my neck as well as the<br />

supraclavicular fossae (soft, depressed<br />

area above each collarbone).<br />

The student palpated each carotid<br />

artery using his/her index and middle<br />

fingers; only one side was examined at<br />

a time.<br />

17. The student listened over each<br />

carotid artery with his/her<br />

stethoscope.<br />

18. Examine thyroid<br />

gland.<br />

The student used a gentle touch and<br />

placed his/her index/middle fingers<br />

under the strap muscle on each side of<br />

my neck to feel my thyroid gland.<br />

19. The student asked me to swallow<br />

while inspecting and/or palpating my<br />

thyroid.<br />

20. Examine chest The student percussed my chest by<br />

applying one finger firmly against my<br />

chest and tapping against it with a<br />

quick and sudden blow from the middle<br />

finger of his/her other hand.<br />

21. The student percussed on the back of<br />

my chest, alternating from one side to<br />

another as he/she moved down (or up)<br />

my chest.<br />

22. The student asked me to take short<br />

deep breaths through my mouth and<br />

then listened to me breathe by placing<br />

the stethoscope firmly against my<br />

chest. The student listened to me take<br />

a complete breath on each side of my<br />

back, each side of my chest and each<br />

side of the front of my chest.<br />

23. Examine heart. The student felt the apex of my heart<br />

using his/her fingertips.<br />

24. The student listened to my heart in at<br />

least four places with the diaphragm<br />

of his/her stethoscope.<br />

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25. Examine<br />

abdomen.<br />

The student listened to my abdomen<br />

with his/her stethoscope before<br />

palpating it.<br />

26. The student initially palpated my<br />

stomach lightly and then more deeply,<br />

in all 4 quadrants.<br />

27. The student’s palpation of my<br />

abdomen was not painful.<br />

28. The student stood on my right side<br />

while examining my abdomen.<br />

29. Palpation of<br />

spleen<br />

The student placed his/her left hand<br />

around the lower edge of my left rib<br />

cage and lifted it gently upwards and<br />

then placed his/her right hand under<br />

my left rib cage. He/she asked me to<br />

take a slow deep breath one or more<br />

times while palpating for my spleen<br />

with the right hand. (Some students<br />

may ask you to roll slightly to the right.)<br />

The student appeared comfortable<br />

and/or confident conducting the<br />

physical examination.<br />

The student conducted the examination<br />

in a smooth, well-sequenced manner that<br />

did not require much repositioning on my<br />

part.<br />

The student used a gentle manner when<br />

handling my body, including palpating my<br />

stomach.<br />

The student respected my modesty<br />

through the use of proper draping or<br />

gowning.<br />

The student’s instructions to me were<br />

clear and easy to understand.<br />

The student did an excellent job in<br />

examining me (OVERALL RATING).<br />

Agree<br />

strongly<br />

Agree<br />

Do not agree or<br />

disagree<br />

Disagree<br />

Disagree<br />

strongly<br />

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