Abstract
Reasons for concern The physical examination represents a link with the history of medicine, and many clinicians have strong opinions on the merits of specific clinical signs. Clinicians have begun to critically review many aspects of physical examination, but this critical approach does not seem to have been applied to the development of checklists for objective structured examinations. Gorter and colleagues reviewed the literature on developing these examinations and found that only 41% of the 29 papers described the process of checklist development. None of the papers reported that checklists were based on the available literature, and only three reported use of published evidence.4