Perceptions of the Cardiovascular Physical Examination Among Academic Clinician Educators in Cardiology

The cardiovascular physical examination (CPE) is a symbolic and valuable component of clinical cardiology practice. Cardiologists working at academic hospitals work alongside trainees, who observe their preceptors as they form their own professional identities. Prior publications describe a waning emphasis on the CPE as imaging technology improves and time at the patient’s bedside decreases. As academic cardiologists are uniquely positioned within this professional evolution, our aim was to investigate their behaviors and philosophies related to the CPE in an effort to understand the resulting impact on their cardiology practice, teaching, and learner assessment. Fourteen cardiologists from academic centers in Chicago (4 women, 8 men) participated in virtual interviews. Their responses were transcribed and organized through an open and focused coding process. Participants’ responses were focused in two areas, professional conflict and individual emotions. They believed that the technique necessary to perform the CPE requires repetition and feedback, which they strived to emphasize in their workplace culture. Subjects also practice using a Hypothesis-Driven Exam approach, where a patient’s symptoms prime the examiner to look for specific findings. Lastly, their professional conflict manifested as a struggle between recognition of the changing environment and the responsibility to uphold the CPE as an endeavor worth teaching and promoting.