New Resources Available to Develop and Enhance Clinicians’ Clinical Reasoning Skills

Society to Improve Diagnosis in Medicine Unveils New Tools and Videos


October 10, 2017 - Today, at its annual Diagnostic Error in Medicine conference, the Society to Improve Diagnosis in Medicine (SIDM) announced two new resources to support physicians in developing the knowledge and competencies needed to improve their diagnostic skills.

According to the National Academies of Sciences, Engineering, and Medicine’s (formerly the Institute of Medicine) 2015 seminal report Improving Diagnosis in Health Care, “most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences.” A key recommendation of the report was to “enhance healthcare professional education and training in the diagnostic process.” Recent research in the Journal of General Internal Medicine found that clinical reasoning is not consistently taught in U.S. medical schools.

The Assessment of Reasoning Tool (ART) – developed by SIDM and leaders in medical education and diagnostic reasoning – provides a framework to evaluate learners’ clinical reasoning skills during their patient presentations. The ART recognizes that the diagnostic process is complex and requires clinicians to develop specific skills that support accurate diagnosis including:

  • Collecting and reporting history and examination data in a hypothesis-directed manner;
  • Articulating a complete problem representation;
  • Articulating a prioritized differential diagnosis;
  • Directing evaluation/treatment towards high priority diagnoses; and
  • Demonstrating the ability to think about their own thinking (metacognition).

“Medical educators are looking for a way to assess their learners and provide feedback on their diagnostic and clinical reasoning skills,” said Satid Thammasitboon, MD, MHPE, Associate Professor of Pediatrics at Baylor College of Medicine and Chair of the Assessment Subcommittee of the SIDM Education Committee. “The SIDM Assessment of Reasoning Tool is an easy-to-use resource that will support educators in their efforts to increase the diagnostic skills of their learners.”

In addition to the ART, SIDM released five new faculty development videos focused on each of the five domains in the ART. The videos were made with support from the ABIM Foundation.

“We have created five faculty development videos that offer medical educators tips on how to use the tool to assess their students and residents,” added Andrew Olson, MD, FACP, FAAP, Assistant Professor of Medicine and Pediatrics at the University of Minnesota Medical School, and co-chair of the SIDM Education Committee. “The videos briefly explain the relevant clinical reasoning principle and then provide teachers with a framework to evaluate their learners around each of the competencies.”

Getting It Right: Cases to Improve Diagnosis – The Getting It Right module includes learning cases that practicing physicians can use to think about diagnostic decision-making, how diagnostic errors may affect patients and physicians, and how diagnostic errors can be mitigated by physicians. The cases were developed by SIDM in collaboration with the American College of Physicians (ACP) and are available for free on ACP’s website. Physicians can earn both CME credit and American Board of Internal Medicine (ABIM) Maintenance of Certification points by completing the modules. Non-ACP members can set up a free account to access the cases.

“Many practicing clinicians were never taught the basics of how we make diagnostic decisions on a daily basis and the potential pitfalls in an otherwise remarkably accurate process that is so critical to good patient care,” said Philip A. Masters, MD, FACP, Executive Editor of Getting It Right. “These clinically-based cases are intended to help care providers understand how we all make diagnostic decisions and can seek to improve our own diagnostic accuracy, engage our patients in the diagnostic process, and know better how to respond to diagnostic errors when they occur.”

The learning cases cover the following topics:

  • Understanding the Diagnostic Process;
  • Analyzing Cognitive and Systems Contributions to Diagnostic Errors;
  • Partnering with Patients and Families in the Diagnostic Decision-Making Process;
  • Physician and Patient Factors in Diagnostic Decision-Making; and
  • Recognizing and Responding to Diagnostic Errors.

“Clinical reasoning is a fundamental skill to ensuring a timely and accurate diagnosis for patients. These new tools showcase the need for physicians to learn and develop that skill in training and then reinforce their knowledge with learning activities throughout their careers,” added Paul Epner, Executive Vice President for the Society to Improve Diagnosis in Medicine. “We are proud to partner with the American College of Physicians and others to ensure that physicians have access to continuing learning activities to further develop their diagnostic skills.”

About the Society to Improve Diagnosis in Medicine (SIDM)
SIDM is a nonprofit organization whose members include clinicians and other healthcare professionals, patients, and every stakeholder in the diagnostic process. SIDM sponsors the annual Diagnostic Error in Medicine conference being held October 8-10, 2017 in Boston, MA. In 2015, SIDM established the Coalition to Improve Diagnosis, a collaboration of 35 leading healthcare organizations. Visit to learn more. Follow us on Twitter and Facebook.

About the American College of Physicians (ACP)
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 152,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.

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Errors in clinical reasoning are central factors in many diagnostic errors. SIDM has developed the Assessment of Reasoning Tool to support educators in assessing a learner’s clinical reasoning skills during patient presentations.