← Full lesson and references Paired practice cardsSt Emlyn’s · MLA

Candidate brief Examiner checklist

One learner performs. One learner checks the key steps and gives feedback. Then swap roles. This is a practice aid, not an official mark scheme.

Candidate

Abdominal examination

MLA · Paired examination practice

Your task

You are a medical student. Examine the abdomen. Present your findings and discuss appropriate next steps with the responsible clinician.

Starting information

Practise with a consenting partner, using the equipment and scope agreed before starting.

Suggested practice time: 8–10 minutes for a focused run, followed by feedback. Allow longer to practise the full sequence. This is not an official examination timing.

St Emlyn’s · MLA · Practice aid, not an official mark schemeCandidate card

Show examiner checklist

Examiner / observer

Abdominal examination

Tick the actions you observe. Discuss any step that was not needed for this examination; unchecked boxes are not a score.

Examiner / observer · 1 of 2

Abdominal examination

Preparation · Initial assessment

Agree supervision and any communication or chaperone support before starting. Use a consenting partner for comfortable, non-invasive techniques and provide the equipment needed for the agreed examination. Use a clinical skills model or describe any uncomfortable component.

Preparation

Introduces themself by name and as a medical student.

Confirms the patient’s identity.

Explains the purpose and extent of the examination.

Obtains consent before starting. Key step

Asks about pain and any urgent symptoms. Key step

Performs hand hygiene.

Uses appropriate protective equipment.

Provides suitable exposure and privacy, keeping other areas covered.

Positions the patient comfortably.

Explains that the patient can ask them to stop. Key step

Initial assessment

Asks about symptoms and the location of pain before palpation. Key step

Inspects comfort, jaundice, distension, scars, drains and relevant skin changes.

Assesses hand warmth and clamminess.

Measures the pulse rate.

Assesses pulse rhythm and quality.

Inspects clubbing, leukonychia, palmar erythema and contractures; checks for asterixis.

Reviews blood pressure, respiratory rate, saturation and temperature; glucose only if indicated.

Checks pallor, lips, mouth and cervical/supraclavicular lymph nodes.

St Emlyn’s · MLA · Practice aid, not an official mark schemeObserver 1 of 2

Examiner / observer · 2 of 2

Abdominal examination

Abdomen · Close

Abdomen

Positions the patient comfortably, inspects the whole abdomen and includes the left flank.

Starts away from pain, palpates gently and watches the patient’s face; does not repeatedly provoke pain. Key step

Assesses tenderness, guarding, rigidity and masses; deeper palpation only when appropriate.

Palpates the liver, spleen, kidneys, bladder and aorta as relevant to the assessment.

Percusses the liver, spleen and bladder and assesses shifting dullness when appropriate.

Listens for bowel sounds and relevant femoral bruits.

Treats any rectal, genital or pelvic examination as a separate, indication-dependent decision. Key step

Close

Restores comfort and privacy, offers help with dressing and thanks the patient.

Ask the candidate

How would you present your findings and their significance? Summarise tenderness, peritonism, distension, masses and organ enlargement. Explain urgency, uncertainty and clinically relevant tests; abdominal radiography is not a universal completion step. Individual peripheral signs or bowel sounds cannot alone establish or exclude an abdominal diagnosis.

What would you do next, and why? Explain the important uncertainty, a relevant next assessment and when help is needed. State what you could not assess.

Feedback

What went well:

One thing to improve:

Try again focusing on:

St Emlyn’s · MLA · Practice aid, not an official mark schemeObserver 2 of 2

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