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Background: Clinical reasoning remains a central skill of the successful clinician. To improve or master these skills, it is essential to outline the cognitive steps that lead to success in eliciting, framing and then solving medical problems. In this era of increasingly hectic time schedules and duty hour restrictions, it is less common for the learner to hear a master clinician’s distinct steps used when solving problems. Moreover, since reasoning transpires largely at the subconscious level, it can be difficult for busy clinicians to articulate the steps in their thought process. Thus, more inexperienced learners are left to pick up reasoning in bits and pieces and to figure out their own way to “connect the dots” when faced with a patient problem. The clinical problem solving/diagnostic reasoning session is designed to provide a window into the master clinician’s thought process and reasoning strategies. The session serves as a valuable tool to learn and teach the process of hypothesis generation (eliciting the right question), problem representation (problem list), prioritized differential diagnosis and finally problem-solving strategies (pattern recognition and analytical reasoning).
Clinical Problem Solving Session Goal: to provide a mechanism for residents to learn the skills and to become more adept at clinical reasoning by listening to expert clinicians talk through process of making decisions and actively participating in discussion around a clinical problem.
Objectives: By making the thought process of a master clinician more transparent, the clinical reasoning session will:
Clinical Problem Solving Session Format:
Introduction to session by the facilitator (5 minutes)
Presentation of case by the facilitator with responses/discussion by master clinicians (30 minutes)
Discussion led by facilitator (15 minutes)
Teaching points and wrap-up led by facilitator as well as completion of survey (5 minutes)