Patient exposure in the basic science classroom enhances differential diagnosis formation and clinical decision-making

Abstract

Purpose. The authors proposed that introducing real patients into a pathology classroom early in medical education would help integrate fundamental principles and disease pathology with clinical presentation and medical history.Methods. Three patients with different pathologies described their history and presentation without revealing their diagnosis. Students were required to submit a differential diagnosis in writing, and then were able to ask questions to arrive at the correct diagnosis. Students were surveyed on the efficacy of patient-based learning.Results. Average student scores on the differential diagnosis assignments significantly improved 32% during the course. From the survey, 72% of students felt that patient encounters should be included in the pathology course next year. Seventy-four percent felt that the differential diagnosis assignments helped them develop clinical decision-making skills. Seventy-three percent felt that the experience helped them know what questions to ask patients. Eighty-six percent felt that they obtained a better understanding of patients’ social and emotional challenges.Discussion. Having students work through the process of differential diagnosis formulation when encountering a real patient and their clinical presentation improved clinical decision-making skills and integrated fundamental concepts with disease pathology during a basic science pathology course.

Impact of Early Clinical Exposure on Psychomotor Skills of Medical Students in Indian Medical Education Set Up

“…18 Justin G. Peacock ( 2015) found , introducing actual patients into a first-year, helped students to develop differential diagnosis formation, history-taking, and basic clinical decision-making skills at an early stage of undergraduate medical education. 19 BJ Medical College, Pune implemented ECE model from 1989 as part of routine practical teaching in Physiology and in the long term found very positive results.…”

Early clinical exposure: Dynamics, opportunities, and challenges in modern medical education

“…By providing students with the opportunity to engage with patients and observe clinical care early in their training, ECE can help to develop the clinical skills, professional attitudes, and patient-centered approach that are essential for success as a physician. [ 9 10 11 ]…”

“…[ 4 5 6 ] Today, ECE programs are an integral part of medical education in many countries around the world. [ 7 8 9 10 11 12 13 ] ECE programs come in many different forms, including shadowing programs, clinical immersion programs, and community-based clinical experiences. They are designed to provide students with direct patient contact, as well as opportunities to observe and participate in clinical care, under the supervision of experienced clinicians.…”

Exploring student perceptions of ward simulation as an exercise to improve decision-making skills in the clinical context

“…Few attempts have been reported in the literature aimed at developing clinical decision-making in the "basic science" years of medical school. However, recent research has demonstrated early encounters with 'real' patients in the classroom environment supports the development of these skills, aiding the eventual transition to clinical practice (Peacock & Grande, 2015). Combining this teaching approach with exposure to simulated exercises, like the AMUWSE, could create an encompassing learning experience for students.…”