logo-ascls-highresIt’s no secret that arriving at a definitive diagnosis in medicine is a complex process involving many “moving parts”.  There is no “cookie cutter” or “one-size-fits-all” approach that can be applied, and very little can be memorized from a textbook or lecture.  Nonetheless, memorization of facts and regurgitation of said facts on written exams is still one of the primary ways our healthcare professionals are taught and assessed during their education and training.  Although the case study approach is more robust and helps to develop critical thinking skills, most educational institutions use “typical” cases in their teaching, which limits students’ abilities to consider atypical, non-standard situations like what they will encounter in real-life practice.

The report from The National Academy Press on Improving Diagnosis in Healthcare recommends that “educators ensure curricula and training programs across the career trajectory employ educational approaches that are aligned with evidence from the learning sciences”1.  As it relates to clinical reasoning, imperative in the diagnostic process, the learning sciences assert that different educational techniques be used.  Employing computer-based simulations, oral examinations, video or audio review of clinical encounters, earlier opportunities to interact with patients, and providing timely feedback to understand and correct errors2, are all examples of techniques educators can use to help students strengthen their clinical reasoning “muscles”.

Medical laboratory professionals and students-in-training have a profound opportunity to assist in improving diagnosis in healthcare, given that laboratory data plays a huge role in clinical decision-making.  When possible, medical laboratory educators need to seek out opportunities for their students to be involved in interdisciplinary communication and decision-making practice, mock “grand rounds”, conversations about test selection and interpretation, and interaction with health information technology.  Gone are the days where laboratory professionals only stay within the 4 walls of the laboratory performing high-quality analyses.  We have so much to offer to improve diagnosis in medicine; it would be unethical to hoard our expertise and knowledge.

1National Academies of Science, Engineering, and Medicine.  2015.  Improving Diagnosis in Health Care.  Washington, D.C.: The National Academy Press.
2Papa, F. J.  Learning sciences principles that can inform the construction of new approaches to diagnostic training.  Diagnosis 1(1): 125-129.  2014.