Identifying and prioritizing educational content from a malpractice claims database for clinical reasoning education in the vocational training of general practitioners

Charlotte G.M. van Sassen*, Pieter J. van den Berg, Silvia Mamede, Lilian Knol, Manon P. Eikens-Jansen, Walter W. van den Broek, Patrick J.E. Bindels, Laura Zwaan

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)
30 Downloads (Pure)

Abstract

Diagnostic reasoning is an important topic in General Practitioners’ (GPs) vocational training. Interestingly, research has paid little attention to the content of the cases used in clinical reasoning education. Malpractice claims of diagnostic errors represent cases that impact patients and that reflect potential knowledge gaps and contextual factors. With this study, we aimed to identify and prioritize educational content from a malpractice claims database in order to improve clinical reasoning education in GP training. With input from various experts in clinical reasoning and diagnostic error, we defined five priority criteria that reflect educational relevance. Fifty unique medical conditions from a malpractice claims database were scored on those priority criteria by stakeholders in clinical reasoning education in 2021. Subsequently, we calculated the mean total priority score for each condition. Mean total priority score (min 5–max 25) for all fifty diagnoses was 17,11 with a range from 13,89 to 19,61. We identified and described the fifteen highest scoring diseases (with priority scores ranging from 18,17 to 19,61). The prioritized conditions involved complex common (e.g., cardiovascular diseases, renal insufficiency and cancer), complex rare (e.g., endocarditis, ectopic pregnancy, testicular torsion) and more straightforward common conditions (e.g., tendon rupture/injury, eye infection). The claim cases often demonstrated atypical presentations or complex contextual factors. Including those malpractice cases in GP vocational training could enrich the illness scripts of diseases that are at high risk of errors, which may reduce diagnostic error and related patient harm.

Original languageEnglish
Pages (from-to)893-910
Number of pages18
JournalAdvances in Health Sciences Education
Volume28
Issue number3
DOIs
Publication statusPublished - Aug 2023

Bibliographical note

Funding Information:
This study was funded by ZonMW, Grant Number 839130012, from the HGOG funding program for Research of Medical Education.

Publisher Copyright:
© 2022, The Author(s).

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