Background: Diagnostic errors have been cited as a potential contributor to hospital readmissions, particularly early readmissions (e.g. within 7 days), but little is known about their frequency and characteristics. We performed structured chart review of all medical patients readmitted within 7 days of discharge from a single academic medical center to describe the prevalence of [...]

Background: Diagnostic errors have been cited as a potential contributor to hospital readmissions, particularly early readmissions (e.g. within 7 days), but little is known about their frequency and characteristics. We performed structured chart review of all medical patients readmitted within 7 days of discharge from a single academic medical center to describe the prevalence of [...]

Background: Development of diagnostic reasoning is a critical component of medical education, and feedback related to clinical outcomes is an important means of calibrating one’s diagnostic decision-making. The hospital is a key training ground for the development of skills in diagnostic reasoning. However, given the multiple provider handoffs that now occur during the care of [...]

Background: While understanding the cognitive contributions to diagnosis has become important, few studies have aimed to understand physician diagnostic reasoning in real-time. Using a case-based approach, we sought to: (a) characterize differences in diagnostic reasoning among hospitalists; and (b) identify factors associated with diagnostic accuracy. Methods: A total of 10 hospital medicine attending physicians from [...]

Background: Diagnostic errors have been cited as a potential contributor to hospital readmissions, particularly early readmissions (e.g. within 7 days). A single prior study of early readmissions applied a binary (yes/no) metric to assess for diagnostic error in early readmissions, but this may be an insensitive method. Past studies of diagnostic error in primary care [...]

Background: Preclerkship medical education promotes the concept of clinical certainty through multiple choice testing and diagnostic reasoning curricula focused on System 1 thinking, namely illness scripts and pattern recognition (1). Clerkship medical education reinforces this concept via diagnosis driven didactic sessions and limited physician-led discussions of management uncertainty (2). Yet, clinical uncertainty is an inherent [...]

Background: Educational efforts targeting diagnostic reasoning have been proposed by the National Academy of Medicine as a means to reduce diagnostic errors. Building on situativity theory, which describes how the context in which we reason impacts our diagnostic ability, teaching diagnostic reasoning should ideally occur in tandem with patient care. Tracking patient outcomes can improve [...]

Background: A crowning step upon graduation from internal medicine (IM) residency training is the successful completion of the American Board of Internal Medicine (ABIM) licensing exam. ABIM Initial Certification Exam pass rates declined significantly during the COVID-19 pandemic from the preceding 4-year rolling test rate for first-time takers. Graduates of our IM residency training program [...]

Background: Developing contextualized curricula in diagnostic reasoning and clinical decision-making is crucial to improve medical education (1,2). Barriers to transition from classroom-based to workplace curricula include workflow constraints, the absence of standardized tools to assess clinical reasoning, the complexity of decision making, and outdated teaching methods (3,5). Aimed to bridge these gaps, we developed the [...]

Case Presentation: A previously healthy and ambulatory 34-year-old diabetic man presented with left-sided scrotal and groin cellulitis and was admitted to the hospital for intravenous antibiotic therapy. He was placed on appropriate pharmacoprophylaxis for venous thromboembolic disease and was observed ambulating on the unit. Despite one week of appropriate antibiotic therapy, he continued to have [...]