Learning to do physical exams is a really fun exercise in faking it. We have these standardized patients who are actors who let us mangle them and then help us with our techniques, but only if we ask. Otherwise we are supposed to pretend that we are their actual doctor. We know many techniques, but only in theory, so many conversations sound like this:
"Alright Mrs. Jones, would you mind untying the back of your gown? You are going to feel my stethoscope, and each time you do, I'd like you to take a deep breath, I'm going to be listening to your lungs...am I listening to your lungs?"
"No dear, that's my shoulder"
"Your shoulder sounds great"