On teaching clinical reasoning – all about case conferences

When we studied ward attending rounds, the thought process represented the top attribute that learners valued.  Learners can learn facts from textbooks, but using those facts requires experience and role modeling. I have given many lectures on clinical reasoning and I have attended many lectures on clinical reasoning.  These lectures can entertain, but one lecture does little to help our colleagues and our learners. We must structure case conferences as a primary way to teach and learn.  Lectures may help occasionally, but often the information in a lecture leaves our memory quite rapidly.  But a case discussion gives the story bones on which to attach the meat! Many years ago I had GI distress and hives after a seafood lunch.  For years I thought I had developed a scallop allergy.  Then I heard a similar case presented with a diagnosis of scombroid.  That one case made my diagnosis, and has helped me make several more diagnoses. At our institution we address case conferences in several ways.  The majority of our morning reports use case presentations with a clinician discussing the case as it unfolds.  Residents often rate these conferences as the number two learning opportunity in residency (after daily rounds).  At our Grand Rounds, while we often have pure lectures, we do have occasional CPCs that remain quite popular.  Our GIM noon conference has both CPCs and CPS (clinical problem solving).  We do CPS every month with 1 attending physician presenting patient...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs