Council on Medical Student Education in Pediatrics


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COMSEP Meeting in Ottawa, ON

Poster Presentation:

CLIPPettes: Teaching Clinical Reasoning Through Short Cases

Glen A. Medellin,,San Antonio,TX,Stephen . Tinguely,,Grand Forks,ND

Background: Clinicians use multiple tools to solve clinical problems. Clinicians form cognitive illness scripts to organize key features of presenting symptoms to facilitate rapid recognition of patient diagnoses. Advanced organizers (AO) deliver content to provide a conceptual framework in preparation for study or practice. There are currently no web based instructional programs that combine these elements, and little is known about student’s perceptions of these teaching tools.


Objectives:   Describe the development and student perceptions of an online proof-of-concept module comprised of a symptom-based AO and simulated patient cases comparing and contrasting different presentations of the presenting symptom.


Methods/Description of Innovation:  The AO presented illness scripts of 5 common causes of acute pediatric cough. This content was linked to 2 short cases in which students identified key clinical features, created summary statements and developed management plans.  It was also linked to 3 self-assessment cases. An online survey combining Likert scales and free text answers was developed to gauge student acceptability of the cases. The online module and survey was peer reviewed by members of the CLIPP editorial board.  Volunteer fourth year students who had used CLIPP previously completed the module and the survey.  Descriptive statistics and thematic analysis of the free text answers was performed on student responses.


Results:  Twelve students from 3 medical schools completed the survey.  The advanced organizer was felt to be a useful framework to organize knowledge (81%), but no student referred back to it when completing the cases. Most students (75%) felt more engaged with the short cases, and 83% of students thought the short cases helped them reach the correct diagnosis better than traditional CLIPP cases.  All felt that the self-assessment cases were useful. Suggestions for improvement included embedding links to the AO within the case and having a printable version of the AO available.


Discussion: Students find online modules utilizing illness scripts engaging and useful.  Next steps include development of modules based on other presenting symptoms and designing research studies to determine the relative importance of the module components for acquisition of clinical reasoning skills and knowledge.