TY - JOUR
T1 - Improving diagnosis by improving education
T2 - A policy brief on education in healthcare professions
AU - Graber, Mark L.
AU - Rencic, Joseph
AU - Rusz, Diana
AU - Papa, Frank
AU - Croskerry, Pat
AU - Zierler, Brenda
AU - Harkless, Gene
AU - Giuliano, Michael
AU - Schoenbaum, Stephen
AU - Colford, Cristin
AU - Cahill, Maureen
AU - Olson, Andrew P.J.
N1 - Publisher Copyright:
© 2018 Walter de Gruyter GmbH, Berlin/Boston 2018.
PY - 2018/9/25
Y1 - 2018/9/25
N2 - Diagnostic error is increasingly recognized as a major patient safety concern. Efforts to improve diagnosis have largely focused on safety and quality improvement initiatives that patients, providers, and health care organizations can take to improve the diagnostic process and its outcomes. This educational policy brief presents an alternative strategy for improving diagnosis, centered on future healthcare providers, to improve the education and training of clinicians in every health care profession. The hypothesis is that we can improve diagnosis by improving education. A literature search was first conducted to understand the relationship of education and training to diagnosis and diagnostic error in different health care professions. Based on the findings from this search we present the justification for focusing on education and training, recommendations for specific content that should be incorporated to improve diagnosis, and recommendations on educational approaches that should be used. Using an iterative, consensus-based process, we then developed a driver diagram that categorizes the key content into five areas. Learners should: 1) Acquire and effectively use a relevant knowledge base, 2) Optimize clinical reasoning to reduce cognitive error, 3) Understand system-related aspects of care, 4) Effectively engage patients and the diagnostic team, and 5) Acquire appropriate perspectives and attitudes about diagnosis. These domains echo recommendations in the National Academy of Medicine's report Improving Diagnosis in Health Care. The National Academy report suggests that true interprofessional education and training, incorporating recent advances in understanding diagnostic error, and improving clinical reasoning and other aspects of education, can ultimately improve diagnosis by improving the knowledge, skills, and attitudes of all health care professionals.
AB - Diagnostic error is increasingly recognized as a major patient safety concern. Efforts to improve diagnosis have largely focused on safety and quality improvement initiatives that patients, providers, and health care organizations can take to improve the diagnostic process and its outcomes. This educational policy brief presents an alternative strategy for improving diagnosis, centered on future healthcare providers, to improve the education and training of clinicians in every health care profession. The hypothesis is that we can improve diagnosis by improving education. A literature search was first conducted to understand the relationship of education and training to diagnosis and diagnostic error in different health care professions. Based on the findings from this search we present the justification for focusing on education and training, recommendations for specific content that should be incorporated to improve diagnosis, and recommendations on educational approaches that should be used. Using an iterative, consensus-based process, we then developed a driver diagram that categorizes the key content into five areas. Learners should: 1) Acquire and effectively use a relevant knowledge base, 2) Optimize clinical reasoning to reduce cognitive error, 3) Understand system-related aspects of care, 4) Effectively engage patients and the diagnostic team, and 5) Acquire appropriate perspectives and attitudes about diagnosis. These domains echo recommendations in the National Academy of Medicine's report Improving Diagnosis in Health Care. The National Academy report suggests that true interprofessional education and training, incorporating recent advances in understanding diagnostic error, and improving clinical reasoning and other aspects of education, can ultimately improve diagnosis by improving the knowledge, skills, and attitudes of all health care professionals.
KW - diagnosis
KW - diagnostic error
KW - education
KW - interprofessional
KW - training
UR - http://www.scopus.com/inward/record.url?scp=85059827888&partnerID=8YFLogxK
U2 - 10.1515/dx-2018-0033
DO - 10.1515/dx-2018-0033
M3 - Article
C2 - 30145580
AN - SCOPUS:85059827888
SN - 2194-802X
VL - 5
SP - 107
EP - 118
JO - Diagnosis (Berlin, Germany)
JF - Diagnosis (Berlin, Germany)
IS - 3
ER -