Balancing Clinical Reasoning Education: Tipping the Scale toward Management Reasoning

Clinical reasoning, composed of diagnostic and management reasoning, is a fundamental skill internal medicine trainees seek to become proficient in and experienced physicians strive to master. Much interest and educational focus is placed on diagnostic reasoning (how to arrive at the correct diagnosis), while management reasoning (the science and art of management strategies) is frequently overlooked. While there are several resources to help learners sharpen their diagnostic reasoning there are few resources to help learners refine their management reasoning and help guide educators in teaching management reasoning. In this workshop, presenters will tip the scale to focus on management reasoning using evidence-based and freely available tools. Management scripts provide learners with a conceptual framework to consider all aspects of management (medications, monitoring, consultants, procedures, follow up, etc) and determine an ultimate management plan based on patient values, high value care, diagnostic uncertainty, and case complexity. Notably, management scripts are a living and iterative framework that are constantly refined during and after a final diagnosis is made. The focus of this workshop will be to use clinical cases and facilitator-led discussions to introduce participants to the concept of management reasoning, facilitate real-time practice developing and refining management scripts, and teach participants how to incorporate this into their own educational conferences. The workshop is designed to allow participants to immediately apply these newly acquired skills and tools towards teaching management reasoning to internal medicine trainees at their home institution.