Calgary-Cambridge Guide to Communication in the Physical Examination

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Introduction[edit | edit source]

Good communication is an essential practice that has shown to improve the patient's willingness to engage in the treatment[1].

Clinical examination is facing a challenge concerning its accuracy and importance. The advancement in research has proven low reliability and validity of many clinical tests with higher rates of accuracy associated with imaging and scans[2]. However, when the subject is approached from cost-effectiveness and availability point of view the perspective changes. Access to advanced medical diagnostic tools geographically and the affordability of such tests differed from a place to another. Therefore, clinical examination is still a valuable tool in clinical practice.

Despite being the golden standard, laboratory testing and imaging if misused could be harmful[3] and could be contributing to overdiagnosis, leading to further psychological and behavioural harms[4].

A thorough and effective physical examination is considered to be an art that is not only important for proper diagnosis but also builds the patient-healthcare relationship. Lack of physical examination is perceived by the patients as insufficient attention [3]. Interpersonal aspects and good communication increase the patient's satisfaction[5].

A study by Hinchliffe and Lavin [6] found the physiotherapist's communication with the patient to be a key factor in patients satisfaction and compliance with the treatment.

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Resources[edit | edit source]

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References[edit | edit source]

  1. Kourkouta L, Barsamidis K, Lavdaniti M. Communication skills during the clinical examination of the patients. Progress in Health Sciences. 2013;3(1):119.
  2. Fourie M. Communication in the Physical Examination. Physioplus Course 2021
  3. 3.0 3.1 Asif T, Mohiuddin A, Hasan B, Pauly RR. Importance of thorough physical examination: a lost art. Cureus. 2017 May;9(5).
  4. Singh H, Dickinson JA, Thériault G, Grad R, Groulx S, Wilson BJ, Szafran O, Bell NR. Overdiagnosis: causes and consequences in primary health care. Canadian Family Physician. 2018 Sep 1;64(9):654-9.
  5. Jalil A, Zakar R, Zakar MZ, Fischer F. Patient satisfaction with doctor-patient interactions: a mixed methods study among diabetes mellitus patients in Pakistan. BMC health services research. 2017 Dec 1;17(1):155.
  6. Hinchliffe NC and Lavin N (2018) Why do patients with low back pain choose not to engage with physiotherapy following assessment? International Journal of Therapy & Rehabilitation. 25(3): 120-127.