From Practicing Medicine to Deliberately Practicing Medicine
Monday, March 19: 9:45 am to 11:15 am
There is increasing evidence that expertise in any field is most effectively developed through deliberate practice – repeated, focused activities with specific goals, consistent feedback and tireless commitment to improvement. One of the most important areas of focus in Internal medicine training is the development of diagnostic reasoning abilities. Despite this focus and the draw that complex diagnostic reasoning has for those who choose Internal medicine, there is substantial room for improving diagnostic performance. Overconfidence abounds and diagnostic errors remain prevalent. Strikingly, almost all diagnostic reasoning skills in residency are learned through caring for patients and thus developing and refining illness scripts rather than through formal curricula. Residents certainly practice making diagnoses, but there are few formal means to ensure that this practice is deliberate and thus likely to lead to expertise formation.
This workshop will focus on applying the principles of deliberate practice to diagnostic reasoning. Using two successful programs as exemplars, this workshop invites attendees to develop locally implementable approaches to build systematic feedback processes and identify effective methods to learn from real cases to develop and refine learners diagnostic skills. After a brief introduction to deliberate practice and exemplar programs, attendees will identify what open feedback loops exist in their training programs and how these loops may be effectively and pragmatically closed. Attendees are invited to identify challenges to implementing such innovations and how these challenges will be overcome. Ample time will be left for discussion and learning from other attendees.
- Attendees will identify open feedback loops with respect to diagnostic reasoning in their training programs as well as two pragmatic, potential options to close these loops.
- Attendees will discuss the principles of deliberate practice and how educational programs may be adapted to embrace these principles.
- Attendees will discuss how learning from one’s own decisions is more effective in leading to behavior change than other less personal learning modalities.
Andrew Olson, MD, FACP, FAAP
Kathleen Lane, MD
University of Minnesota Medical School
Robert L. Trowbridge, MD
Maine Medical Center
Juan N. Lessing, MD
University of Colorado School of Medicine