SCRIPTING SUCCESS: USING A POINT-OF-CARE APP AT THE BEDSIDE TO ENHANCE STUDENTS CLINICAL REASONING SKILLS
Chandler Todd,Department of Pediatrics,Albuquerque,NM; Kristen Bettin,University of Tennessee Health Science Center,,; Jonathan Gold,Michigan State University College of Human Medicine,,; Kyra Len,University of Hawaii John A. Burns School of Medicine,,; Erin M. McMaster,University of Massachusetts Medical School,,; MacKenzie Hillard,Weill Cornell University School of Medicine,,

Rationale:

Clinical reasoning is a critical skill we expect all students to acquire prior to graduation, but remains a challenge to teach in medical school. Many experienced clinicians utilize illness scripts as tools for clinical reasoning by incorporating new information into existing mental maps, by comparing different diagnoses, and predicting clinical outcomes. Teaching medical students how to use illness scripts can serve as a foundation for future clinical reasoning.  However, illness scripts require some knowledge of and experience with the specific diseases or conditions, which novice students often lack.  By developing a point of care (POC) tool with sample algorithms and illness scripts, we provide a framework for students to learn clinical reasoning by improving data gathering and generation of differential diagnoses.  



Objectives:
  1. Recognize current theories of clinical reasoning with focus on illness scripts 
  2. Develop illness scripts to use as teaching tools 
  3. Apply illness script teaching tool, PedsScripts App, in clinical teaching scenarios


Methods and Content:

Participants will be introduced to the concept of illness scripts through an ice breaking activity. A brief didactic session will review key features of illness scripts and their role in organizing medical knowledge for advanced and novice learners.  In a breakout session, participants will practice building their own illness scripts for diagnoses from the COMSEP diagnosis table.  Next the PedsScript App will be demonstrated as a POC tool to use with students, and participants will generate ideas for its use in different learning vignettes.  Wrap up will include a brainstorming session for next steps, with an opportunity to submit illness scripts developed in the workshop to be included in the PedsScript App Version 2.0.

Timeline: 

5 min – Introduction  

10 min – Think Pair Share - clinical reasoning pitfalls of early clinical students  

10 min – Ice Breaking activity – "Illness Script" to identify Art or Music Genre 

15 min – Clinical Reasoning / Illness Script Didactic  

30 minutes Active Learning: Develop Illness Scripts. Share process. Turn in for submission to PedsScript 2.0 

10 min – Demonstration of POC tool  

20 min – Skill Building: Group practice using the PedsScripts App tool –giving each table a clinical scenario and/or a learner description 

15 min – Wrap up—brainstorming for other ways to use the tool and future ideas for home institution 

 Equipment: LCD projector, screen, flipchart, Internet access, Video/Sound