Signs vs symptoms: The challenges of assessing patients
One of the courses I teach is called ‘clinical assessment’. It can be very challenging for the students because it requires them to draw from previous learning (e.g. anatomy), learn new information (e.g. how to assess various joints in the body), and then integrate that learning into clinical practice. Students can often be overwhelmed with the depth and breadth of the material. Sometimes they get overwhelmed because the information is new and they are expected (although not initially) to be able to develop a clinical impressions as to what is bothering the patient. Sometimes I will encourage the students to differentiate the terms signs and symptoms. All too often they are lumped together. Symptoms are things like pain, weakness or altered sensation. To help with the student’s understanding I often prompt them to think about the signs (i.e. where the symptoms arise). For example, a patient may have weakness and pain in the hand due to something happening at the hand (which is often the default for the new learner) or something happening further up the body (e.g. perhaps a nerve being compressed in and around the neck). Prompting my students to explore the signs allows them to further develop their clinical reasoning and to think more about their own thinking.
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