A comparison of two methods for facilitating clinical data integration by medical students

Two important charting strategies to help students organize patients' data are Weed's problem-oriented medical record (POMR) and Russell's condition diagram (CD). The authors conducted the present study in 1987 to determine whether either was superior for clinical data integration. Sophomore medical students at The University of Texas Medical School at San Antonio indicated whether they preferred the POMR, the CD, or neither. They were then divided into three study groups according to their preferences, with the POMR and CD groups receiving 80 hours of training and the control group receiving only the standard preclinical training. Each student then examined a standardized patient and wrote an open-ended report about the patient's medical problem. After examining a second patient, students were asked to write a structured report providing information about each of ten components of diagnosis. Both the CD and the POMR groups scored numerically higher on the structured type of report than did the controls, but only the CD group scored significantly higher. The CD group also scored higher than did the POMR group on both types of report, but the differences were not statistically significant. This study indicates that the clinical reasoning of medical students can be enhanced by focused training in either the CD or the POMR methods. It suggests that the CD format may be particularly helpful for students with lower academic achievement.