MedEdPORTAL (Jan 2015)
Coffee Talks: An Innovative Approach to Teaching Clinical Reasoning and Information Mastery to Medical Students
Abstract
Abstract While clinical reasoning (CR) and information mastery/evidence-based medicine (IM/EBM) are, along with clinical experience and knowledge of the patient, essential for the practice of medicine, few medical schools have adequate CR training or a formal IM/EBM curriculum through all 4 undergraduate years. Recent data have shown that CR skills plateau after the second year of medical school, with a lack of accelerated progress during the clinical years of training. The above-stated concepts led to our novel approach establishing a 4-hour case-based conference titled “Coffee Talks,” where third-year students bring cases seen during their month of family medicine. The typical forum includes three to four trained faculty (EBM-resource librarian, EBM preclinical course director, EBM clinical course director, and experienced clinicians) and 12-14 students during their family medicine clerkship. The thinking skills of medical students are enhanced by faculty-led discussions of the cases in formulating a working differential that is assessed and modified after each segment of the presentation. Students then identify key clinical questions that have arisen during the discussion and perform an evidenced-based review of that question. The discussions are focused around key points of the differential, diagnostic decisions, and treatment regimens based upon available data presented by the student. Small-group working teams with assigned faculty are then tasked to utilize EBM resources in answering the identified questions. This is followed by a student-led discussion in the larger forum that enables the students to recognize the cognitive skills utilized daily by family physicians in the care of their patients. Our experience and the evaluations of our students have shown that a student-led, faculty-facilitated conference is an effective format to highlight the concepts of clinical reasoning, and the use of valid evidence-based resources to enhance and impact clinical decision-making. Coffee Talks has been well received as a valuable learning environment for students to practice and utilize clinical reasoning and information mastery as well as a refreshing approach to medical education for our participating interdisciplinary faculty.
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