Interactive Team-Based Approach to Multiple Clinical Scenarios: A Third-Year Medical Student Exercise

Abstract Introduction This is a multi-station, team-based practical exercise in clinical decision-making designed for third-year medical students. This exercise places students in the role of attending physicians who encounter multiple clinical scenarios in a variety of common primary care situations such as supervising medical students, addressing medical urgent issues, and fielding patient phone calls. The exercise is designed to be collaborative, wherein a small group of students comprises the attending physician team and confers on appropriate decision-making steps in each scenario. Methods Students form teams of three to four, and teams rotate through the three stations over the course of the session. In the last minutes of each station, teams record their assessments and plans in an online Google Document form and submit it to the session instructors. Once teams finish at all three stations, the entire group reassembles for a central debrief to review the key learning points and display the answers that the teams submitted. Questions and free-form discussion take place at this time. Discussion during the central debrief typically highlights student engagement with the diagnosis/decision-making process, as the differentials generated vary among groups, and each is enthusiastic about defending and supporting their own line of reasoning. Results Verbal feedback after the session's conclusion indicated that many students felt that a great deal of learning happened from the time-limited nature of the exercise, which they felt mirrored real-life pressures they had seen. Written feedback in the days following the session emphasized this point again and stated that the wide variety of case topics was helpful in relearning and refreshing approaches to various clinical problems. Discussion Our set of simulation scenarios provides students with multiple clinical scenarios to promote clinical reasoning and decision making in a simulated setting more representative of the cognitive, organizational, and time-limited reality of clinical practice.