A web-based peer feedback tool for physical examination

Background: Medical students do not have many formal opportunities to practise physical examinations during their pre-clerkship years. Consequently, they often practise their examination skills with peers outside of formal teaching sessions. There are also few opportunities for observation and feedback on their skills in this area. Context: The undergraduate medical programme at the University of Toronto is a 4-year programme where students learn clinical skills in the first 2 years prior to beginning clinical rotations. Innovation: We describe a web-based, mobile device-friendly tool to facilitate structured peer-peer observation and feedback of physical examination skills. The tool is designed for use by pre-clerkship medical students, and includes assessment criteria for select physical examinations based on expectations for pre-clerkship medical students. In addition, supplemental instructional material was developed to aid the students' learning. The tool was piloted with first-year medical students as they prepared for their autumn objective structured clinical examination (OSCE) at the University of Toronto. Its use was voluntary. Implications: The tool has been used enthusiastically by students, and their feedback has been positive. This tool is an innovation that guides students as they practise their physical examination skills, and gives them a framework to provide feedback to one another during this process. It also encourages students to reflect critically on their own skills, as well as those of their peers, through the use of an engaging digital platform. The tool will be expanded to include history-taking vignettes, photos and videos. The tool is sustainable, and could be easily implemented at other institutions without a substantial investment.