Using the NAM diagnostic process framework to teach clinical reasoning in computerized case presentations to 251 medical students.

Abstract

Explicit education on diagnostic reasoning is underrepresented relative to the burden of diagnostic errors. Medical educators report curricular time is a major barrier to implementing new curricula. The authors propose using concise student-identified educational opportunities -- differential diagnosis and summary statement writing -- to justify curriculum development in diagnostic reasoning. Eighteen clerkship and 235 preclinical medical students participated in a 1h computerized case presentation and facilitated discussion. Students were surveyed on their attitudes toward the case. All 18 (100% response) clerkship students and 121 of the 235 preclinical students completed the survey. Students felt the module was effective and relevant. They proposed medical schools consider longitudinal computerized case presentations as an educational strategy. A computerized case presentation is a concise instructional strategy to teach critical points in diagnosis to clerkship and preclinical medical students.