25 techniques to improve trainees' bedside skills

"Stanford 25" is a list of 25 fundamental physical examination techniques and their diagnostic benefits developed by Stanford Medical School to teach the interns to improve their skills at the bedside. It is published in the Christmas issue of the BMJ.


Abraham Verghese, professor of medicine at Stanford, wrote in the editorial, that the bedside skills of trainees in the US are declining as a result of the over-use of modern diagnostic tests. He argued that physical examination along with the taking of a good history are necessary and important in the diagnosis of clinical signs because many of them such as rebound tenderness, lid lag, tremor etc cannot be detected by an imaging test. He said that the Stanford 25 also gives "junior faculty members a repertoire of skills to teach when they are at the bedside."

Editorial : "In Praise of the Physical Examination", Abraham Verghese, Ralph Horwitz. BMJ 2009;339:b5448