How to make a tuning fork vibrate: the humble pisiform bone

A tip for using an old diagnostic tool

While recently observing medical students undertaking an ear, nose and throat examination in an observed structured clinical examination, I watched with interest how each of them attempted to make the tuning fork vibrate. Knowing well that the Rinne and Weber tests were an essential part of the examination technique, they each carefully selected a fork and, almost to a student, proceeded to stumble over the process of making the thing buzz. A couple of students used the heel of their shoe (not particularly decorous), one cracked it on her knee (ouch!), a few tried to squeeze and quickly release the tines (pretty tricky with a C-512 Hz fork), while others, not knowing any better method, gave it a deafening whack on the nearest bit of furniture.