PHYSICAL-THERAPISTS INSTRUCT MEDICAL-STUDENTS IN MUSCULOSKELETAL EXAMINATION

Physical therapists and occupational therapists at the Veterans Administration Hospital, San Diego, California, in conjunction with nearby University of California, San Diego Medical School, have been instructing small groups of second-year medical students in musculoskeletal examination as the orthopedic contribution to a course entitled 'Introduction to Clincal Medicine'. The four-hour session, designed and executed by the orthopedic service, consists of two 3-minute lecture-demonstrations by an orthopedic surgeon and two patient-examination sessions of one hour and 45 minutes. Physical therapists and occupational therapists demonstrate, discuss with, and direct students in: surface inspection and palpation of joints, muscles, and bony landmarks; determination of range of motion and muscle strength; observation of basic components of gait; examination of status of sensation and reflexes; and administration of surface tests for ligamentous stability and joint-tissue pathology. Students are encouraged and assisted in carrying out these tests themselves on patients in a consistent and structured manner and to record results on a form produced especially for the class. General principles, rather than specific pathology, are emphasized. No other sessions given by the other clinical components of medicine use health care professionals in such a direct way.