Innovative Curriculum Helps Medical Students Reduce Diagnostic Error

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Innovative Curriculum Helps Medical Students Reduce Diagnostic Error

Monday, June 26, 2017

Diagnostic accuracy is the foundation of safe, effective medicine. However, diagnostic error is the leading cause for malpractice claims in the U.S.

It is estimated that 1 in every 10 diagnoses is wrong or delayed, and 1 in 20 patients will experience a diagnostic error every year in ambulatory clinics.

Because most medical schools lack formal curricula focused on the diagnostic process, many medical students are forced to learn about diagnostic errors the hard way -- when they first make them.

"Most medical students don't learn the techniques and tools they need to avoid diagnostic error and improve the diagnostic process early on," said Paul Epner, executive vice president and co-founder of the Society to Improve Diagnosis in Medicine (SIDM). "Earlier education on what leads to these errors -- and how to prevent them -- is essential to reduce the risk of patient harm."

In an effort to reduce diagnostic errors, SIDM and MedU, a nonprofit consortium of medical educators and developer of virtual patient courses, have developed a first-of-its-kind curriculum for U.S. medical students called "DX: Diagnostic Excellence." Development of the curriculum was funded by a $200,000 grant from The Doctors Company Foundation.

The DX course and its supporting in-classroom learning materials will be distributed via MedU's online learning platform, which is used by more than 90 percent of medical schools in the U.S. Over 500 students at seven medical schools have participated in the curriculum's pilot program. The course and materials will be available free of charge to medical education institutions through MedU for the 2017 to 2018 subscription year beginning July 2.

Andrew Olson, MD, Medicine and Pediatrics, University of Minnesota, and project manager of the curriculum pilot program, attributes a few factors to the education gap in diagnostic safety.

"Most students still learn by doing, instead of proactively learning about what could go wrong," Dr. Olson said. "Yet historically, there have been questions about the capacity of medical students to learn about diagnostic error, including concerns that students will get scared and that the information will be destructive so early in their careers. Our goal was to explore the best way to make this information relevant and accessible, but not damaging, for medical students."

The "DX: Diagnostic Excellence" curriculum includes six full-length cases and six shorter assessment cases on the online MedU platform, allowing students to experience realistic clinical situations in which a diagnostic error occurs and to gain skills to prevent and handle diagnostic errors. Each interactive module assists students in recognizing and avoiding pitfalls in the diagnostic process, while providing methods for creating discourse around everyday errors.

"We've seen that the online module is truly the best way to not only bring the clinical setting to life for the student in a safe and approachable way, but also to make the classroom content adaptable for a variety of universities," Dr. Olson said.

Epner also emphasized that the modules are designed to educate students on the team-based nature of care and to help students better empathize with patients and those who make the errors.

"There are many factors and stakeholders leading up to a diagnostic error -- and like in a relay race, often the last person in the chain will unfairly get the blame," Epner said. "Our course helps medical trainees understand that diagnosis is a team sport."

"DX: Diagnostic Excellence" also supports classroom content designed and provided by SIDM and MedU to help faculty bring the learnings to life and empower students to become more comfortable discussing difficult topics. Some universities have leveraged the materials as in-class activities, while other schools with students spread out across the nation have utilized webinars for their online discussion.

"We launched this project on a leap of faith with the support of The Doctors Company Foundation," Dr. Olson said. "After two years, we've helped medical student education to enter a new frontier in diagnostic safety and shown how students have enormous potential to be advocates for patient and diagnostic safety."

To learn more about The Doctors Company Foundation, visit