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Clinical Reasoning as a Core Competency.

Denise M Connor1, Steven J Durning2, Joseph J Rencic3

  • 1D.M. Connor is associate professor of clinical medicine, Department of Medicine, and director of the Diagnostic Reasoning Block, School of Medicine, University of California, San Francisco, and associate program director of PRIME, an area of distinction for internal medicine residents based at the San Francisco Veterans Affairs Medical Center, San Francisco, California.

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Improving medical education is key to reducing diagnostic errors. Integrating clinical reasoning into the Accreditation Council for Graduate Medical Education (ACGME) core competencies will drive innovation and better prepare physicians.

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Area of Science:

  • Medical Education
  • Healthcare Quality Improvement
  • Patient Safety

Background:

  • Diagnostic errors pose a significant challenge in healthcare, often stemming from issues in clinical reasoning.
  • Despite calls for improvement, the development of clinical reasoning curricula and assessment tools in medical education has been slow.

Purpose of the Study:

  • To advocate for the inclusion of clinical reasoning within the Accreditation Council for Graduate Medical Education (ACGME) core competencies.
  • To accelerate innovation and research in clinical reasoning education across health professions.

Main Methods:

  • This is a conceptual and advocacy-based proposal, not an empirical study.
  • It analyzes the potential impact of revising ACGME core competencies.

Main Results:

  • Revising ACGME core competencies to include clinical reasoning is predicted to stimulate educational innovation and scholarship.
  • This reform could foster inter-institutional collaboration in physician training.

Conclusions:

  • Integrating clinical reasoning into ACGME core competencies is essential for advancing medical education.
  • This change has the potential to reduce diagnostic errors and patient suffering by enhancing physician preparedness.