Detection and correction of house staff error in physical diagnosis

N. P. Wray and J. A. Friedland

A significant number of errors in physical examination can be detected when house staff are observed by attending physicians. In this study, observation of residents and interns showed a total error of 13.1% and 15.6%, respectively, with incorrect findings of 3.3% and 4.9% and omitted findings of 9.8% and 10.7%, respectively. Approximately two thirds of all patients examined had at least one error noted. A method was instituted for detecting and correcting these errors that can be integrated into daily attending rounds. Using this method, a statistically significant decrease in the number of errors was shown. The method used emphasizes the physical examination pertinent to the patient's main problem, consumes very little rounding time, and is well received by both attending physicians and house officers.

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