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Al b any Medical College

Al b any Medical College. Diagnosing Differential Diagnostic Resources in a Pediatric Clerkship Enid M. Geyer, MLS, MBA and D. Elizabeth Irish, MLS Albany Medical College, Schaffer Library of Health Sciences, Albany, NY Richard H. Sills, M.D.

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Al b any Medical College

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  1. Albany Medical College Diagnosing Differential Diagnostic Resources in a Pediatric Clerkship Enid M. Geyer, MLS, MBA and D. Elizabeth Irish, MLS Albany Medical College, Schaffer Library of Health Sciences, Albany, NY Richard H. Sills, M.D. Upstate Medical University, Department of Pediatrics, Syracuse NY. OBJECTIVE: To integrate the use of differential diagnostic resources to support clinical decision making in a third year pediatric clerkship through (1) introducing Computer-assisted Learning in Pediatrics Program (CLIPP) cases and (2) comparing and analyzing the differences/similarities between the CLIPP case and DXplain diagnosis. METHODS: A collaboration was established between the Library theme (LMI) and the Pediatrics Clerkship. Students gained experience with differential diagnostic (DDx) in the eight week clerkship through the use of (1) Computer-assisted Learning in Pediatrics Program (CLIPP) cases and (2) assignments that had them compare and analyze a CLIPP case and the corresponding DXplain diagnosis. Since September 2004, a one hour session is taught by pediatric faculty or residents with library faculty assistance. The physician guides the students through a CLIPP case, soliciting responses to questions and providing a framework for the disease. The LMI assignment requires the students to complete a CLIPP case, run the same case through DXplain, and compare the results. At the end of each rotation an evaluation is distributed. In June 2006 the third and fourth year students were surveyed to determine the usefulness of the CLIPP cases. RESULTS: • 331 assignments submitted between 2004 - 2006 were reviewed: • 257 assignments compared the DDx of a CLIPP case to the same case run in DXplain • 74 compared DDx of a real patient case to DXplain results. • Of the CLIPP cases, 74% found the diagnosis within the top 5 of “common” or “rare” diseases in DXplain categories, while 66% running a real patient diagnosis in DXplain found the same diagnosis within the top 5. • Students identified difficulty entering terminology and social history as reasons for not arriving at the same or similar DDx. • Students recognized that DDx tools complement rather than replace physician expertise. • CONCLUSIONS: • CLIPP cases are a valuable tool to build upon students’ DDx skills and clerkship knowledge base. • DXplain helps students identify components needed to build a reliable DDx. • DXplain combined with clinical judgment provides helpful guidance in formulating a DDx. • STUDENT CLIPP SURVEY COMMENTS (conducted in 2006): • 73% found CLIPP cases useful or somewhat useful. • 73% were satisfied or somewhat satisfied with CLIPP cases. • 81% found the CLIPP cases easy or somewhat easy to use. • 47% would recommend CLIPP cases to other students. • 50% might recommend CLIPP cases to other students.

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