Technically, there is no single course in medical school devoted to uncovering the correct diagnosis. Instead, the entire curriculum aims to teach budding physicians how to identify medical problems, perform an examination and think critically to reach an accurate conclusion.
But after the National Academies of Sciences, Engineering and Medicine released a 2015 report called “Improving Diagnosis in Health Care,” which revealed high rates of diagnostic error and related harm to patients, physicians around the world took notice. And Dr. Timothy Mosher, chair of the Department of Radiology at Penn State College of Medicine, decided to do something about it: develop a medical school course aimed at identifying systemic causes of misdiagnosis-and how to prevent them.
“We are working hard to come up with practical solutions for what we can do to reduce diagnostic error,” says Mosher, who is also a professor of radiology for the College of Medicine. “We’re starting with students-getting them aware of the problem so that as they develop their career, they’ll be thinking about how to bring error prevention into their daily activities.”
Mosher’s students first learn about the frequency and causes of diagnostic error, which is defined as either a failure to correctly and promptly identify a health problem or a failure to communicate the diagnosis to the patient. The class then considers the National Academies’ list of recommendations for real-world ways to identify, address and reduce diagnostic error. Working as a team, the students investigate a practical opportunity for improvement. So far, three groups of students have taken the course.
“The class is totally unique, giving undergraduate medical students a chance to learn about diagnostic error and think about these things while they’re still in their formative years,” says Dr. Mark Graber, founder and president of the Society to Improve Diagnosis in Medicine and a national leader in patient safety. “It’s the first such course in the country, but I’d like to see every school have a course like this. Health care needs to wake up to the problem of diagnostic error and provide more education and training to address it.”
Mosher, who also serves on the board of directors for the Society to Improve Diagnosis in Medicine, says the overall course goal is concept design.
“We want students to understand the background of the problem so they can think critically for the rest of their career,” he says. “This course takes largely a systems-based approach, bringing the entire picture of care and the health care system to bear on the process of making accurate diagnoses.”
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