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Preparing for Discharge: A Workshop on Communicating Diagnostic Uncertainty

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Abstract

Learning Objectives: Demonstrate a workshop designed to teach third year medical students how to communicate diagnostic uncertainty.

Background: Diagnostic uncertainty abounds in medicine. Effectively communicating that uncertainty is critical to high-quality patient care. There is a gap in training preparing medical students for communicating diagnostic uncertainty. The Uncertainty Communication Checklist (UCC) is a framework to effectively communicate diagnostic uncertainty to emergency department patients at discharge.

Educational Objectives: We developed a workshop to address a curricular gap in preparing medical students to communicate diagnostic uncertainty to patients. Its objectives were to introduce learners to diagnostic uncertainty, discuss the importance of effective communication during times of diagnostic uncertainty, describe key steps for effectively communicating uncertainty, and practice communication through peer role-play.

Curricular Design: We designed a workshop leveraging the UCC and role-play scenarios for third-year medical students. The virtual workshop was conducted at the conclusion of their core clerkships. Prework included reflection prompts and an interactive online module. The workshop began with a didactic lecture to reinforce these materials. Students completed a peer role-play in which a provider must discharge a patient from the Emergency Department with an uncertain diagnosis. The session concluded with small group faculty facilitated debrief sessions.

Impact: Anonymous post-session survey data (76% response rate; 202/265) indicated that most (82%; 152/185) students felt more comfortable with communicating diagnostic uncertainty after the workshop. A majority (83%; 166/201) indicated it was useful, and most (81%; 149/184) felt it should be included in the curriculum in the future. Further studies are needed to identify students’ comprehension and application of uncertainty communication training.

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