1. Take a comprehensive history from a simulated patient and formulate a professional detailed narrative written record.
2. Understand and apply physical diagnosis terminology.
3. Apply the psychomotor examination skills of inspection, palpation, percussion auscultation, instrumentation and measuring to the examination of the various systems or areas of the body.
4. Properly employ basic diagnostic instruments and equipment including: the thermometer, stethoscope, sphygmomanometer, otoscope, and ophthalmoscope.
5. Accurately and efficiently obtain and interpret vitals signs on a patient.
6. Identify common normal and abnormal physical examination findings which occur in health and disease.
7. Recognize normal and common normal variants.
8. Identify signs and symptoms of common and notable human ailments.
9. Demonstrate the psychomotor abilities and interpretation of the common general phyiscal examination procedures
   Note: The objectives of this class do not include adjusting, treatment or patient management.
   Treatment and patient management are covered in subsequent system courses, case management classes, clinical chiropractic classes, technique courses, clinical case studies classes etc.
   
   Note: The instructors of the class are not your personal physicians.
   Health questions and personal health problem work-ups should be directed by your own personal doctor and/or the University Health Service.

1. A Guide to Physical Diagnosis and History Taking, Eighth Edition, Bates/Bickley
2. Lecture Outline and Lab Notes (purchase in the bookstore and handed out in class)
3. Students will need to take notes to study from.

1. Reference Materials not required (Recommended Physical Diagnosis Reference Texts if you don't like Bates/Bickley):
   • *Mosby's Guide to Physical Examination, Fourth Edition, Seidel
   • Textbook of Physical Diagnosis, Second Edition, Swartz.
   • The Art and Science of Bedside Diagnosis, Sapira.
   • Physical Diagnosis, Willms, Schneiderman, Algranti.
   • Physical Diagnosis, Burnside/McGlynn.
   • Physical Diagnosis, Schafer.
   • Health Assessment, Malasanos.
   • Physical Examination, Sixth Edition, Prior, Silberstein and Stang.

2. Recommended General Reference Texts: (reference books that I like)

• Differential Diagnosis and Management for the Chiropractor 3rd Ed. Souza
• Merk Manual, Berkow (Also available in CD-ROM and on line) (Good for looking up conditions for the history simulation)
• Atlas of Clinical Medicine, Forbes/Jackson (Also available in CD-ROM)
• Clinical Examination, Epstein (Also available in CD-ROM)
• Interactive Atlas of Human Anatomy, Netter, CD-ROM
• Clinical Methods, Walker
• Symptomatology and Differential Diagnosis, Schafer.
• Differential Diagnosis in Primary Care, Collins.
• Signs and Symptoms, Blacklow.
• Bedside Diagnostic Examination, Degowin and Degowin.
• The 5 Minute Clinical Consult, Griffith and Dambro. CD-ROM

1. Diagnostic equipment and supplies (listed in the bookstore/discussed in class)
2. All students (men and women) wear examination gowns to all labs except lab 1 (history) and lab 3 (non neck head examination)
3. Women will need a bikini top or bra for the lung and thorax lab, neck vessels and heart lab and practical exam number 2.
4. A towel to be used as a drape is needed for the abdomen lab and practical exam number 2.
5. Loose shorts are required for the peripheral vascular lab and lab practical #2.

1. Attend all the lectures
2. Do not skip one class to study for another
3. Sit in the front row
4. Take your own notes to study from
5. Study to learn and understatd - memorization works for anatomy - not diagnosis
6. Read the text
7. Read the lab manual before the lab.
8. Most lecture presentations are done in Microsoft PowerPoint
9. The lecture outline and required textbook are available in the bookstore
   1. The lecture outline is an outline - Students need to take notes in class
   2. Assigned chapters are listed in the Weekly Calendar Learning Objectives
   3. Powerpoint presentations are available from this syllabus - details given in class
10. Information covered in lecture, lab and assigned readings in the text needs to be integrated and synthesized by the student outside of class
    1. Do not confuse memorizing the course outline with studying to learn.
    2. Concepts that are understood are retained well and can be applied to new situations - this is necessary to be an outstanding clinician
11. Students are responsible for obtaining information (including copying handouts) for any missed classes.

1. Read the lab notes and appropriate chapter in the text prior to the lab period covering that material.
2. Head, ear, eye, nose, mouth, throat, face, neck, thorax and lung, neck vessels and heart, abdomen and peripheral vascular examinations will be practiced on fellow student doctors.
   • *Students with health related conditions which contraindicate participation in any of the above examinations should notify the instructor during the first week of class.
   • Examination gowns are required for all the labs except: Lab #1 and Lab #3.
   • Women should wear an appropriate swim top or bra for the thorax and lung examination.
3. Breast, genitalia and rectal examinations will be done on plastic simulators.
4. Students are expected to be professional at all times
   • Any unprofessional behavior or attitude should be brought to the attention of the instructor immediately.
5. Recommendations for gaining the most out of the lab experience:
   • Be present for the introduction/explanation and the demonstrations at the beginning of the lab.
   • Make full use of your "captive patient."
   • Pair up with a different partner each lab - gain the experience of examining different sexes and body types.
   • Take your time - and pay attention to the varieties of normal
   • Do more than "go through the motions" of the examination - the value of being familiar with normal will become apparent once you are in clinic.
   • Ask for and give feedback.
   • Be active in the role of patient - much can be learned about examination by being examined.

Email

1. Students need to check their University Email at least weekly.
2. Important inforamtion about the class will be distributed to the class by e-mail.

1. Required
2. Lab
   • Credit for lab is given when the student:
     • Comes to his/her assigned lab section
     • Is present when role is taken (normally at the beginning of lab)
     • Brings all the necessary equipment
     • Is appropriately dressed (When gown is required, no gown, no credit)
     • Actively participates as doctor and patient for the entire lab period
   • Students may have one excused absence during the term

1. The tests will require application/understanding of the information.
2. Cramming for the tests in this class will likely be ineffective. Don't fall behind!
3. There are three written examinations in this class. Precise dates will be determined during the term and announced in class.
   1. Test 1: approximately week 6
   2. Test 2: approximately week 11
   3. Final Test: during finals week (cumulative, includes course notes, lecture information, assigned readings and lab material)
4. Reviewing written examinations:
   1. The examinations in this course are for assessment (summative) in nature and are not intended to be teaching tools (formative).
   2. Students wishing to view their examination one or two must make arrangements to do so within one week of the score posting for that test.
      1. Arrangements to review the test are made with the faculty secretaries after all students have completed the test.
   3. Students are not allowed to review the final examination.
5. Lab Evaluation:
   1. Based upon attendance, participation in each lab and performance on practical examinations.
   2. Practical #1 Vital Signs
   3. Practical #2 HEENT
   4. Practical #3 Thorax and Abdomen
   5. Practical #4 male/female genitalia, anorectal examination and breast (plastic models)
6. Special examinations:
   1. All students are expected to take the examinations as scheduled with the rest of the class.
   2. Failure to take an examination reaults in a 0 or failure for that examination.
   3. If a test is missed a written request may be submitted that dtails the nature of the emergency situation.
7. Grading The average of the top 10% = 100% for each test
   1. To pass the Physical Diagnosis course the student must demonstrate minimal competency by:
      a. Scoring 70% or better on the written evaluations
      b. Passing all the lab practicals of the class (pass/no pass)
   2. History= 4% of the final grade
      Test 1 = 28% of the final grade
      Test 2 = 28% of the final grade
      Final Test = 40% of the final grade
   3. Practical examinations and attendance are graded as pass/no pass and are not used to calculate the final percentage.
   4. Grades are determined by demonstrated performance - grade changes occur only if there is a clerical or mathematical error.
      
8. Posting of grades
   1. Final examination scores will be posted after the last T3 final examination
   2. Make-up exams are allowed only according to the policies described in the current student handbook, which is available in the Student Affairs office.

Guaranteed grades are as follows:

COGNITIVE DOMAIN

PSYCHOMOTOR DOMAIN

AFFECTIVE DOMAIN