We chat once again with Gurpreet Dhaliwal, this time about what it takes to become a master diagnostician. We discuss the main strategies; seeing many cases, deliberate training, getting feedback, closing the loop, and others.
Check out this interesting article Gurpreet authored in JAMA from 2015 about “the greatest generation.”
The Greatest Generation Gurpreet JAMA 2015
And here’s a video of Gurpreet Dhaliwal talking about some of the same issues discussed here- how to become an expert diagnostician.
Nic Chris put me onto this. Great work.Nice balance of informality and seriousness. I recently read Slow Medicine by Victoria Sweet. She writes about her evolution as a doc and her stories reminds us how we have to slow down sometimes when a diagnosis does not make sense and re-examine and go look things up to get to the right diagnosis. Re the discussion about the importance of practicing to be better on game day, our rowing coach used to say “if you don’t do it correctly all week long, don’t expect to do it correctly on Sunday on race… Read more »
Thanks Hugh
Very good podcast, thank you. Is it possible for you to provide a link, or summarise the resources that were mentioned please?
Hi Rachel. You can read anything by Anders Ericsson on ‘deliberate practice’ including his 2017 book “Peak” mentioned by another listener. You can Google “Human Diagnosis Project” or download their app. And Gurpreet Dhaliwal has lots online about becoming expert including some YouTube videos.
Fascinating podcast – love the analogy with maths teachers making us show our thinking for the marks, but in diagnosis physicians rarely do that. I advocate the think aloud techniques when rounding!
If you have a reference to any published study on the electronic feedback every fortnight to trainees on cases they have seen and discharge diagnosis I would love to hear about it. Email me j.j.coleman@bham.ac.uk
We are trying to implement that in our hospital in the UK
Hi Jamie- not aware of any published data and alas we’re not collecting any at this point. At first our registrars resisted getting this information, I think because they thought Big Brother’s watching even though it was explained quite explicitly that this data was collected ONLY for educational purposes. It still requires that they keep track of their initial impressions which is not always the case and not so easy to do. We have been trying to put together an app that would ‘match’ discharge diagnoses to initial differentials but this has proven fairly difficult to do from an IT… Read more »
Great podcast – I’ve just read Anders Ericsson’s book “Peak” which sums up his deliberate practice theory, and have been thinking /teaching about this in explaining to my trainees and other clinical colleagues: “how do we learn (to get really good)”. In hospitals where practice, practice, with coaching and feedback may be lacking, we can try other things as mentioned here, also “virtual ward rounds” is something I use on training days – getting my Registrars (senior residents) to review accurate clerk-ins on paper and write their management plan with coaching and feedback from me – never ceases to amaze… Read more »
Well we’ve just added another title to our ‘Must Read’ list! And your virtual rounds sounds pretty innovative- anything to get trainees to see and think about as many cases as possible. Would be interested in hearing how those rounds have been received.