What’s Wrong with Me, Doc? Applying A Curriculum for Communicating Diagnostic Uncertainty in The Emergency Medicine Clerkship
Year: 2023
Type: article
Abstract: Background: Diagnostic uncertainty is ubiquitous in emergency medicine (EM).Training to prepare students to communicate uncertainty with emergency department (ED) patients is limited in UME.Previous work has integrated the Uncertainty Communication Checklist (UCC) in EM resident education.Implementation in the EM clerkship has not yet been examined.We developed a curricular intervention that implements uncertainty training into the EM clerkship for third-year medical students.Objectives: Students will be able to describe diagnostic uncertainty and its impact on patients and provider, explain the UCC during patient conversations, practice using checklist during simulated encounters, and apply the checklist to patient conversations on shift.Curricular Design: At our institution, students complete a required 3-week EM clerkship.Students were first tasked with completing prework in the form of an Articulate Rise module on communicating diagnostic uncertainty.An additional didactic session was included in the clerkship orientation.Students then engaged in peer role play, as either patient or physician during a simulated case of discharging a patient with an uncertain diagnosis.The session ended with a debriefing.While in the department, we assessed students' performance in applying each aspect of the checklist while communicating diagnostic uncertainty with patients through a standardized direct observation tool.Impact: As students grapple with diagnostic uncertainty during their EM clerkship for the first time, the clerkship itself may serve as an ideal time to implement training on navigating these conversations.The breadth of patient encounters in the ED allows for deliberate practice of this skill.The UCC was successfully implemented into our clerkship.Initial data shows that students perform well and complete most elements of the checklist (83%).We plan to continue with implementation, data collection, and dissemination of this innovation.
Language: English
Subfield: Family Practice
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $500
OpenAlex ID: W4376983289