I Don't Have a Diagnosis for You: Preparing Medical Students to Communicate Diagnostic Uncertainty in the Emergency Department.

Authors

• Maria Poluch
• Jordan Feingold-Link
• Nethra Ankam
• Jared Kilpatrick
• Kenzie Cameron
• Shruti Chandra
• Amanda Doty
• Matthew Klein
• Danielle McCarthy
• Kristin Rising
• David Salzman
• Deborah Ziring
• Dimitrios Papanagnou

Publication/Presentation Date

1-1-2022

Abstract

INTRODUCTION: Diagnostic uncertainty abounds in medicine, and communication of that uncertainty is critical to the delivery of high-quality patient care. While there has been training in communicating diagnostic uncertainty directed towards residents, a gap remains in preparing medical students to understand and communicate diagnostic uncertainty. We developed a session to introduce medical students to diagnostic uncertainty and to practice communicating uncertainty using a checklist during role-play patient conversations.

METHODS: This virtual session was conducted for third-year medical students at the conclusion of their core clerkships. It consisted of prework, didactic lecture, peer role-play, and debriefing. The prework included reflection prompts and an interactive online module. The role-play featured a patient complaining of abdominal pain being discharged from the emergency department without a confirmed diagnosis. Students participated in the role of patient, provider, or observer.

RESULTS: Data from an anonymous postsession survey (76% response rate; 202 of 265 students) indicated that most students (82%; 152 of 185) felt more comfortable communicating diagnostic uncertainty after the session. A majority (83%; 166 of 201) indicated the session was useful, and most (81%; 149 of 184) indicated it should be included in the curriculum.

DISCUSSION: This virtual session requires few facilitators; has peer role-play, eliminating the need for standardized patients; and is adaptable for in-person teaching. As its goal was to introduce an approach to communicating diagnostic uncertainty, not achieve mastery, students were not individually assessed for proficiency using the Uncertainty Communication Checklist. Students felt the session intervention was valuable.

Volume

18

First Page

11218

Last Page

11218

ISSN

2374-8265

Published In/Presented At

Poluch, M., Feingold-Link, J., Ankam, N., Kilpatrick, J., Cameron, K., Chandra, S., Doty, A., Klein, M., McCarthy, D., Rising, K., Salzman, D., Ziring, D., & Papanagnou, D. (2022). I Don't Have a Diagnosis for You: Preparing Medical Students to Communicate Diagnostic Uncertainty in the Emergency Department. MedEdPORTAL : the journal of teaching and learning resources, 18, 11218. https://doi.org/10.15766/mep_2374-8265.11218

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

35178469

Department(s)

Administration and Leadership

Document Type

Article