Integrating Standardized Multimedia to Supplement Physical Examination Curriculum: An Assessment of Medical Student and Evaluator Perspective.

INTRODUCTION: As a new generation enters the realm of medical education, so do their preferences for technology integration into didactic curricula. An analysis of 106 LCME-accredited medical schools found that 97 percent of programs utilize supplemental e-learning to enhance traditional, face-to-face education in their physical examination curricula. Of these programs, 71 percent produced their multimedia internally. Existing literature indicates medical students benefit from the utilization of multimedia tools and the standardization of the instruction process in the learning of physical examination techniques. However, no studies were found that outline a detailed, reproducible integration model for other institutions to follow. Current literature also fails to assess the effect of multimedia tools on student well-being and largely ignores the educator perspective. This study aims to demonstrate a practical approach to integrating supplemental videos into an existing curriculum and to assess first year medical student and evaluator perspectives at strategic points throughout the process. METHODS: A video curriculum tailored to the Sanford School of Medicine's Objective Structured Clinical Examination (OSCE) requirements was created. The curriculum contained four videos, each designed for a specific examination component - musculoskeletal, head and neck, thorax/abdominal, and neurology examinations. First-year medical students participated in a pre-video integration survey as well as a post-video-integration and OSCE survey assessing student confidence, anxiety reduction, education standardization, and video quality. The OSCE evaluators completed a survey assessing the ability of the video curriculum to standardize the education and evaluation process. All surveys administered were based on a 5-point Likert scale format. RESULTS: Of survey respondents, 63.5 percent (n = 52) utilized at least one of the videos in the series. Prior to implementation of the video series, 30.2 percent of students agreed with the statement, "I am confident in my ability to demonstrate the skills needed to complete the following exam." After implementation, 100 percent of video-users agreed with this statement compared to 94.2 percent of non-video-users. A reported 81.8 percent of video-users agreed that the video series decreased anxiety when performing the neurologic, abdomen/thorax, and head and neck exams, whereas 83.8 percent agreed in the use of the musculoskeletal video series. A reported 84.2 percent of video users agreed the video curriculum standardized the instruction process. OSCE evaluator participation in the survey was 68.8 percent (n=11), and 90.9 percent of these evaluators agreed the videos standardized the education and evaluation process. CONCLUSIONS: Overall, this study outlines the process of augmenting traditional didactic physical examination curricula with multimedia and the support of this process from medical student and OSCE evaluators. Video users report decreased anxiety and increased confidence in performing physical examination skills for the OSCE after integration of the video series. Students and OSCE evaluators found the video series to be a useful tool in the educational process and evaluation standardization.