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Life Is Short, the Art Long, Opportunity Fleeting, Experience Treacherous, Judgment Difficult-Reply

Diane L. Elliott, MD; David H. Hickam, MD, MPH
JAMA. 1988;259(17):2543. doi:10.1001/jama.1988.03720170018014.
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In Reply.  —Dr Conner raises timely issues concerning the value of the history and physical examination for diagnostic decision making. We studied methods for evaluating medical students' mastery of skills for acquiring physical examination information. Another important goal of clinical teaching is to help students use findings to assess alternative diagnoses. Other investigators have developed tools to aid in teaching these skills in data synthesis.1Ms Mueller has emphasized that an effective breast examination is thorough, which has been confirmed by experimental studies.2,3 Patient instructors have been trained to teach the breast examination.4 And, as Drs Stillman, Regan, and Swanson point out, patient instructors may be logically suited to evaluate these skills. The teaching and assessment of the breast examination are often components of instruction in pelvic examination, which is a use of patient instructors provided by most medical schools.5We agree with Drs Stillman, Regan,


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