Lecture by: Leslie H. Fall, MD
Presented at the 2017 CLIME Together Symposium for Excellence in Health Professions Education at the Talaris Conference Center (Seattle, WA)
The 2015 Institute of Medicine report on “Improving Diagnosis in Healthcare” notes that diagnosis and diagnostic errors have been largely unappreciated in efforts to improve the quality and safety of healthcare. One of the primary roles of health care training programs is to help learners develop medical decision-making skills, and to do so with graduated levels of independence. Effective cognitive integration of basic and clinical science concepts plays an essential role in enhancing diagnostic accuracy for novice clinicians. Furthermore, the ability to transfer knowledge obtained in one clinical context to solve a new problem, or the same problem in another context, is critical to the development of clinical expertise.
Unfortunately, many students who have demonstrate adequate basic science understanding in the preclinical curriculum are often unable to apply this knowledge to clinical problem-solving. Meanwhile, the relevant scientific knowledge of both basic and clinical instructors is often encapsulated, challenging their ability to help students learn and effectively integrate and use core concepts. In this hour, we will explore the reasons behind expert knowledge encapsulation, and consider collaborative methods for “unpacking” instructors’ knowledge and reinforcing its connections to clinical decisions in order to facilitate student activation of their basic science knowledge, improving both diagnostic accuracy and long-term retention, towards the ultimate end of clinical entrustment.