Postgraduate Course: Improving Diagnosis (IMED11020)
|School||Deanery of Clinical Sciences
||College||College of Medicine and Veterinary Medicine
|Credit level (Normal year taken)||SCQF Level 11 (Postgraduate)
|Course type||Online Distance Learning
||Availability||Not available to visiting students
|Summary||The purpose of this course will be to focus on improving diagnosis through an understanding of decision making and the causation of imperfect diagnosis.
The course will focus on the dual process theory of decision making, metacognition and critical thinking, alongside the system related factors implicated in diagnostic error.
The assessment for the course will ensure that students demonstrate the use of type 1 and type 2 decision making in diagnosis, and the ability to employ toggling in diagnostic decision making. They will show demonstrable skills in analyzing the causes of diagnostic error, and in investigating and interpreting these.
Diagnosis is a critical praxis which is performed throughout healthcare. Error in diagnosis is therefore a pivotal safety problem, and may inflict significant harm. The US Institute of Medicine has reported that diagnoses are incorrect for one in ten patients. Surveys of patients and their families demonstrate that at least one person in three has first-hand experience with a diagnostic error. Diagnostic error is difficult to measure due to the complexity of the process, and of the clinical landscape in which it takes place. There are some surrogate markers to guide us. In North America malpractice claims for failure of diagnosis far outweigh those for surgical mistakes or medication error. One in twenty primary care patients will experience a diagnostic error every year.
The Institute of Medicine has defined diagnostic error as the failure to (a) establish an accurate and timely explanation of the patient's health problem(s) or (b) communicate that explanation to the patient. Diagnoses may be delayed; missed; incomplete; wrong; or a combination of these.
Our understanding of the causation of diagnostic error is improving. Most commonly, diagnostic error stems from interactions between the complexity of the diagnostic process, the complicated nature of healthcare provision, and the thinking and decision making of those formulating the diagnosis.
This course is structured as an online distance learning course which will educate current doctors who are clinically active in the key areas involved in clinical decision making and diagnosis. These include, but are not limited to, demonstrating a working knowledge of Type 1 and Type 2 thinking in dual process theory, the importance of critical thinking in clinical practice and the diagnostic process, and the application of toggling to decision making in diagnosis, and differential diagnosis.
The student should also be able to show applied knowledge of analyzing why diagnostic error occurs, including the practical performance of root cause analysis and cognitive autopsy to explicate the causes of diagnostic error.
Entry Requirements (not applicable to Visiting Students)
||Other requirements|| None
Course Delivery Information
|Academic year 2018/19, Not available to visiting students (SS1)
|Learning and Teaching activities (Further Info)
Seminar/Tutorial Hours 5,
Online Activities 30,
Programme Level Learning and Teaching Hours 2,
Directed Learning and Independent Learning Hours
|Assessment (Further Info)
|Additional Information (Assessment)
||Written Exam 0 %, Coursework 100 %, Practical Exam 0 %
|No Exam Information
On completion of this course, the student will be able to:
- Critically analyse the main theoretical models of decision making
- Apply the forefront principles of critical thinking to the diagnostic process
- Conceptualise the issues which increase complexity in clinical diagnosis
- Make informed judgements in clinical diagnosis, in the presence of uncertainty
- Develop a range of specialised practices, including root cause analysis and cognitive autopsy, to identify the causes of diagnostic error
|Key articles will be referred to at relevant points during the course.|
|Graduate Attributes and Skills
||Within the work to be undertaken this course will provide participants with the opportunity to develop or further develop key graduate attributes:
¿ In-depth knowledge of specialist discipline
¿ Develop new understanding by exercising critical judgement and challenging knowledge
¿ Be a self-directed learner
¿ Solve problems effectively taking ethical, professional and environmental issues into account
¿ Use information responsibly in a range of contexts
¿ Collaborate with others, capitalising on their different thinking, experience and skills
¿ Communicate (oral, written, online) effectively, respectful of social and cultural diversity
¿ Application of numeracy
¿ Application of IT
|Keywords||Diagnosing,improving diagnosis,medical assessment,internal medicine
|Course organiser||Dr Graham Nimmo
|Course secretary||Mrs Krislyn McWilliams-Biles
Tel: (0131 5)37 2506