Training on clinical reasoning in US med schools

Peggy Zuckerman peggyzuckerman at GMAIL.COM
Thu Aug 31 22:02:33 UTC 2017


In patient-ese, I ask, "What else should we be be teaching these people?"

Peggy Zuckerman

Peggy Zuckerman
www.peggyRCC.com

On Thu, Aug 31, 2017 at 7:10 AM, John Brush <jebrush at me.com> wrote:

> I gave a lecture to the second year class at Eastern Virginia Medical
> School 2 weeks ago on “The Logic of Medicine.” I talked about the
> systematic thinking, cognitive psychology, and probability theory that can
> provide the underpinning for medical decision-making. It was on “how" to
> think through medical problem-solving. It was a bit philosophical about the
> “why” and the “ought,” but I had enough examples to make it realistic and
> not too philosophical. It had the feel of a TED talk. The class was riveted.
> I received enormously positive feedback. The students crave this type of
> exposure to an overall philosophical approach that gives them a basic
> “mission statement” for practice. After the talk, 2 class members who are
> the officers in the local Evidence-based Medicine Club asked me to give a
> talk at their next meeting. They have asked the course director to include
> more of this type of thing in their course offerings.
> Students have an appetite for this type of explicit instruction if they
> get a little taste of it. It displaces other topics, however, so getting it
> into the curriculum is a challenge - but possible.
> John
>
> John E. Brush, Jr., M.D., FACC
> Professor of Medicine
> Eastern Virginia Medical School
> Sentara Cardiology Specialists
> 844 Kempsville Road, Suite 204
> Norfolk, VA 23502
> 757-261-0700 <(757)%20261-0700>
> Cell: 757-477-1990 <(757)%20477-1990>
> jebrush at me.com
>
>
>
>
> On Aug 31, 2017, at 6:58 AM, Jason Maude <jason.maude at ISABELHEALTHCARE.COM
> <jason.maude at isabelhealthcare.com>> wrote:
>
> Many congratulations to Joe Renic and his colleagues for this study which
> is brilliant but left me both horrified and speechless.
>
> It does a real service by shining a light on this huge gap in national
> medical education. We all accept that clinical reasoning is a fundamental
> part of being a good doctor so how can we have arrived at a situation where
> even poor or fair students only receive a total of 6.4 hours of dedicated
> instruction on this topic?
>
> Isn’t this a bit like pilots only getting a tiny amount of their overall
> training on take-offs?!
>
> Regards
> Jason
>
> Jason Maude
> Founder and CEO Isabel Healthcare
> Tel: +44 1428 644886 <+44%201428%20644886>
> Tel: +1 703 879 1890 <(703)%20879-1890>
> www.isabelhealthcare.com
>
>
>
> *From: *Mark Graber <Mark.Graber at IMPROVEDIAGNOSIS.ORG
> <Mark.Graber at improvediagnosis.org>>
> *Reply-To: *Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.
> IMPROVEDIAGNOSIS.ORG <IMPROVEDX at list.improvediagnosis.org>>, Mark Graber <
> Mark.Graber at IMPROVEDIAGNOSIS.ORG <Mark.Graber at improvediagnosis.org>>
> *Date: *Tuesday, 29 August 2017 at 14:38
> *To: *"IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> <IMPROVEDX at list.improvediagnosis.org>" <IMPROVEDX at LIST.
> IMPROVEDIAGNOSIS.ORG <IMPROVEDX at list.improvediagnosis.org>>
> *Subject: *[IMPROVEDX] Training on clinical reasoning in US med schools
>
> Congratulations to Joe Rencic and colleagues for this important article on
> teaching clinical reasoning in US med schools.  A survey of clerkship
> directors with a high response rate found that less than half of schools
> have a formal curriculum on clinical reasoning, and that 80% were
> dissatisfied with student reasoning competency at the end of the clerkship.
>
> This is an area where SIDM is highly engaged and trying to improve the
> current state of affairs.  Most of the authors of this paper are members of
> SIDM and the SIDM Education Committee.  There are many excellent resources
> for educators on the SIDM website, in particular the items in the Clinical
> Reasoning Toolkit <http://www.improvediagnosis.org/page/ClinicalReasoning>
> .
>
>
> Mark L Graber, MD FACP
> President, SIDM
> Senior Fellow, RTI International
> Professor Emeritus, Stony Brook University, NY
> <image001.png>
>
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> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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