SIDM's priority: Translating ideas into action

Marius Laurent marius.laurent at SKYNET.BE
Thu Nov 5 15:34:39 UTC 2015


Pat,

I like your proposition, but I must confess my surprise seeing your
affirmation about numerous studies proving the role of thinking failure in
diagnosis errors, and about meta-analytic studies demonstrating the efficacy
of critical thinking training. I desperately look for such evidences, maybe
you can help me?

Marius

 

De : Pat Croskerry [mailto:croskerry at EASTLINK.CA] 
Envoyé : mercredi 4 novembre 2015 21:52
À : IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Objet : Re: [IMPROVEDX] SIDM's priority: Translating ideas into action

 

Mark: these all look worthwhile initiatives.

I’d like to add a further one: given that a number of studies now point to a
significant proportion of diagnostic failure being due to thinking failures,
and given that meta-analytic studies demonstrate conclusively that by far
the most effective way of improving reasoning and problem solving skills is
through critical thinking interventions, I advocate for the introduction of
critical thinking interventions at UGME and PGME. Others have already
designated critical thinking as a meta-competency and some programs have
embarked on this in separate initiatives. Others in the ethics domain have
strongly proposed that this be done as an ‘ethical imperative’, and, given
the unacceptably high estimates of preventable deaths from diagnostic
failure it’s hard to argue with that.

Rather than each inventing our own wheels, how about developing a generic
Critical Thinking Module that would be available off the shelf that medical
educators could use? The content could be approved by a consensus committee.
This would be an inexpensive project with potentially high returns.

Pat



On 11/04/15 12:43 PM, Mark Graber <
<mailto:mark.graber at IMPROVEDIAGNOSIS.ORG> mark.graber at IMPROVEDIAGNOSIS.ORG>
wrote:


With the IOM report now officially out on the street, SIDM is now focused on
how to change practice to improve diagnosis.  The "Coalition to Improve
Diagnosis" will be our first priority; the Coalition steering committee has
had several meetings already, and the next steps are for each organization
to identify at least one action they can take, and for all the members to
agree on a common action. The Coalition will also be growing very soon to
include another set of key national organizations.

 

We are also urging federal agencies to step up to the plate.  Founding Board
member David Newman-Toker represented SIDM at a meeting yesterday of the
AHRQ National Advisory Committee, and publicly thanked AHRQ for being a key
supporter of our efforts through funding of our Diagnostic Error
Conferences, the IOM report itself, and through the new R01 and R18 grant
funding to study diagnostic error they have recently made available. We
asked the NAC to support 3 initiatives deriving from the IOM report:  1)
Developing a Common Format for organizations to report diagnostic errors to
their Patient Safety Organizations; 2) Working with DOD, HHS, VA and others
to develop the national research priorities for diagnosis, and to develop a
public-private partnership to promote research; and 3) Providing dedicated
funding for AHRQ to support research on diagnostic error in proportion to
the harm associated with diagnostic error.

 

Later this month I'll be addressing a group at the CDC to emphasize the
actions we'd like to see them take: 1) Resurrect the clinical pathologist
position by providing funding for this type of consultation; 2) Resuscitate
autopsies at key designated centers as a way to learn about errors; 3) Help
develop and use failsafe procedures for test reporting; and 4) Use second
opinions in anatomic pathology.  

 

We'll provide updates on these activities as they come up, and would love to
hear about initiatives that the listserv readership might also know about,
or be involved with.

 

  Mark

 

Mark L Graber MD FACP
President, SIDM  www.improvediagnosis.org <http://www.improvediagnosis.org> 
919 990-8497
 
<https://webmail.eastlink.ca/iwc/svc/wmap/attach/Logo%20-%20Medium%20PNG.png
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