Clinical skills textbooks fail evidence-based examination

Despite advances in ''technological'' medicine, the history and physical examination still provide the correct final diagnosis in the majority of cases 1 2 and remain the cornerstone of clinical medicine. 3 Medical students spend a great deal of time learning these techniques. Students continue to be taught the long case ''complete history and physical,'' despite its inefficiency and errors. Bordage 4 claims ''you see what you are looking for,'' and gathering further data fails to increase diagnostic accuracy. Educational research suggests diagnostic accuracy depends on both mastery of knowledge and sound problem solving strategies. tudents can learn to problem solve more expertly by using schemes that assist storage and retrieval of clinical knowledge, rather than rote memorisation of lists and ''dispersed'' knowledge.