Taking the stress out of morning report: an analytic approach to the differential diagnosis

J Gen Intern Med. 2009 Jun;24(6):747-51. doi: 10.1007/s11606-009-0953-5. Epub 2009 Mar 31.

Abstract

Introduction: Morning report is a traditional core teaching session in most departments of internal medicine where learners present cases to a facilitator who uses the material to teach clinical reasoning. It instills fear in both learners and teachers because they may embarrassingly miss diagnostic possibilities including even the actual diagnosis.

Aim: The two teaching tips described here enable the learner and the teacher to fall back on a routine approach to arriving at a differential diagnosis list.

Description: The first tip describes how to elicit the ten "focal findings" in the case that best summarize the data used to derive a diagnosis list. The second tip describes a matrix of etiologies and systems that can be used to generate the diagnostic probabilities.

Discussion: This approach is easy to teach and, where all else fails when coming up with a diagnosis, can be used to prompt the discussion of what is wrong with the patient.

Publication types

  • Comparative Study

MeSH terms

  • Attitude of Health Personnel*
  • Clinical Competence
  • Diagnosis, Differential*
  • Humans
  • Internship and Residency / methods
  • Stress, Psychological* / psychology
  • Teaching* / methods