David Smith, M.D. 

**Not to be taken concurrently with required M3 or M4 clerkships**

Elective duration is part-time for 4 weeks (worth 2 weeks elective of credit).

Graded Pass/Fail only.

Goal:
This course provides an opportunity for students interested in any specialty to strengthen skills in diagnostic reasoning and clinical problem solving.
1. Become comfortable with the language and methods of clinical reasoning
2. Have applied those methods of clinical reasoning to a live discussion and weekly cases
3. Produce content for peer education

Background:
The transition between the preclinical and clinical years of medical school is pivots on the application of knowledge studied in preparation for the USMLE Step 1 exam to the students’ time on the wards. To succeed on the floors, and soon as a physician, it’s not enough to be able to regurgitate facts or correctly answer multiple choice questions. It becomes imperative not to just arrive at a correct conclusion, but to be able to clearly communicate the clinical reasoning a student used to arrive at that conclusion. These skills are often left to the “hidden curriculum,” through observing attendings and residents discuss treatment plans on rounds and participating in morning reports and case conferences while on the wards. An additional opportunity to learn diagnostic reasoning would be beneficial for students in the clinical years of medical school.

Description:
Clinical Reasoning is an important area of medical education; this elective will provide three elements of teaching in to strengthen students’ skills in diagnostic reasoning. Those three areas include: (1) Didactic exposure to the terminology and theories of clinical reasoning, (2) Active participation in case discussions, (3) Guided production of educational content to be shared with peers.

During this elective, students will
a) Encounter didactic material introducing them to the concepts and methods of clinical reasoning
b) Watch 1 video morning report (live/recorded), recording teaching points regarding clinic reasoning and diagnostic approach to a commonly encountered clinical problem
c) Participate in 2 required live case discussions, and have the opportunity to participate as discussants/presenters
d) Submit evolving problem representations for cases released in aliquots each week (3 cases total)
e) Produce 2 diagnostic schema
f) Produce 2 illness scripts
g) Present 1 schema or illness script in a required discussion session
h) Complete a reflection on what they learned about diagnostic reasoning, and how they will use the skills gained going forward

The course will be graded according to the following scale:
- Pass/Fail

Requirements:
Students must complete all of the following to achieve a Passing grade for the elective:
a) Meet with the course director (virtually is acceptable) at the start of the elective to discuss the expectations
b) Submit key points from didactic material on theories of clinical reasoning
c) Submit key teaching points from 1 video morning report
d) Submit evolving problem representations for cases weeks 1-3
e) Participate in 2 course facilitated case discussions
f) Develop and submit 2 diagnostic schema and 2 illness scripts. The schema/illness scripts must include 3-4 references.
g) Present 1 schema or illness script to the large group
h) Submit a reflection after completing the elective coursework using the SSOM RFLCT rubric