There are four standard methods of physical examination that healthcare professionals use to assess their patients. These physical examination methods rely on the knowledge and understanding of what is normal to help identify medical issues. These methods are:
- Inspection: Taking cues from what is visually observed
- Palpation: Gaining information from what is felt and what the patient feels as the healthcare practitioner palpates the body
- Percussion: The percussive notes heard and interpreted in the context of the medical complaint
- Auscultation: using a stethoscope to listen to sounds within the body
The knowledge gathered through these four standard processes will aid practitioners in assessing and diagnosing patients’ functional health issues. The information gained from a thorough physical examination will give clinicians an overall picture of the patient and help them identify any other underlying problems patients may have.
While a patient may complain of one health problem, the examining clinician may pick up on other clues indicating further health concerns. For example, is the patient appropriately dressed for the current weather? Are they struggling to make or maintain eye contact? Does their facial expression indicate they are in pain? Are they finding it difficult to hold a conversation with you? Are they walking, standing or sitting awkwardly in a way that is not directly related to the health issue they are presenting with?
Physical clues gained during an assessment
A clinician’s hands can reveal many underlying issues the patient may have. You can pick up clues from the moment you shake hands with the patient as they introduce themselves. For example, if the patient’s hand feels hot or cold and clammy, this can indicate an underlying virus, infection or even a peripheral vascular problem.
During a physical examination, clinicians can assess the patient’s muscle tone, reflex, limb strength, weakness or spasticity through palpation. The early clues can then lead the clinician to narrow down and identify issues that the patient may or may not be aware of.
Physical palpation can indicate abnormalities such as masses, systemic infection or crepitus, musculoskeletal issues, and conditions affecting the skin, lymph nodes, abdomen or respiratory system.
Of the four standard physical assessment practices, the most challenging technique to learn is the percussion of the body cavities. Percussion is a valuable tool for identifying several health conditions. The clinician picks this up as a change of percussion sound or note as they percuss over bones, masses, fat, fluid, lung tissue etc. Percussion uses your dominant hand’s middle or index and middle fingers as the drumstick to tap on the middle phalanx of your non-dominant middle finger that rests on the patient’s body. The drumming sound can indicate fluid, gas or growths in body cavities.
Auscultation using a stethoscope aids clinicians in listening to the deeper sounds made within the body. Different types of stethoscopes are suitable for the patient group you are assessing. For example, a paediatric advanced nurse practitioner working with babies and children will need a paediatric stethoscope with a smaller head.
PDUK provide a range of professional training courses aimed at health professionals such as nurses, clinicians and allied healthcare workers. We highly recommend the following five-day hands-on workshop for medical practitioners involved in diagnostic and clinical decision-making.
A03 Five-day patient assessment skills workshop: Face to Face
This skills workshop is held over five days and is a hands-on programme to deliver high-quality, practical skills to medical practitioners involved in clinical assessment and decision-making.
The course involves primary medical history taking and physical examination techniques involving real-life subjects. This will enable you to develop confidence and in-depth knowledge of assessing adult patients.
PDUK can offer you a tailor-made in-house patient assessment skills workshop. We can design a one-to-10-day programme with you, matching staff needs, patient requirements and available resources.
This five-day hands-on workshop is designed for all registered nurses, allied health professionals such as pharmacists and paramedics, community matrons, district nurses, health visitors, medical students, modern matrons, nurse practitioners, occupational health nurses and physiotherapists.
The course runs from 10:00 am- 5:00 pm Monday-Thursday, per the agreed test-out appointment on Friday and will include morning and afternoon refreshments.
Workshop participants will:
- Learn and use the principles of taking a safe, structured patient history.
- Be able to apply physical examination techniques appropriately for each of the major body systems.
- Perform a complete structured physical examination.
- Identify normal and common abnormal findings encountered while conducting a patient examination.
- Document findings in a clear, concise manner.
All course material is included, including a workplace competency workbook, evaluations and a certificate of attendance provided.
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