Objective Standardized Clinical Examinations (OSCEs) Fail To Identify Students With Below-Average Diagnostic Reasoning

In an interesting preliminary study, the authors find that many fourth-year students who pass the OSCE checklist, by performing adequate numbers of history and physical exam maneuvers and identifying the correct diagnosis, are unable to adequately describe their diagnostic reasoning.  Two main categories of diagnostic errors were identified:  premature closure of the diagnostic process, and failure to recognize common symptoms patterns.  Another study to confirm the validity and reproducibility of the diagnostic reasoning instrument would be useful. — Laura Willett, MD

Williams RG, Klamen DL.,Examining the diagnostic justification abilities of fourth-year medical students., Acad Med. 2012 Aug;87(8):1008-14.

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