Diagnostic grand rounds in undergraduate medical education.

摘要

Context and setting A new integrated medical curriculum was implemented at the Medical University of Vienna in the winter term of 2001. The last 2 years of the 12-term (6-year) undergraduate medical training focus on the extension of clinical skills. Students are prepared for practical tasks in clinical routine after graduation. Diagnostic science was included in the new curriculum in order to teach students about indications for, investigation with and interpretation of diagnostic methods and their appropriate uses in the clinical setting. Why the idea was necessary Diagnostic tests had been taught thus far without reference to the patient's medical history. Students and young medical graduates found it difficult to apply their knowledge of diagnostic tests and select the appropriate test method in routine clinical practice. What was done Diagnostic grand rounds (DGRs) were implemented in Year 5 of medical training and held every 2 weeks for 2 hours. The lessons were focused on patient histories. The purpose of learning was to enable students to select the appropriate diagnostic test. Experienced representatives of various clinical departments presented case studies through computer presentations or patient interviews in the lecture hall. Students participated actively in the lessons. Based on the patient's symptoms, students were asked to state suspected diagnoses by completing diagnostic forms and to answer specific questions by voting. After discussing the patient's suspected diagnosis, determining the diagnosis and deciding on diagnostic methods, the test itself was explained. Reasons for selecting a specific diagnostic method in a particular situation were explained. For practical instruction, diagnostic methods were presented live in the lecture hall using manikins or video clips. In DGRs students learn to structure information and apply standards to select the appropriate test. Students are trained to integrate their knowledge of clinical tests and clinical symptoms in order to treat patients. The purpose is to encourage diagnostic reasoning.