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60 Optimizing overdiagnosis education for medical students
  1. Sadaf Ekhlas,
  2. Eddy Lang,
  3. James Dickinson
  1. University of Calgary, Cumming School of Medicine, Calgary, Canada

Abstract

Objectives Understanding overdiagnosis is difficult for healthcare workers, both in theory and in practice. At it’s core it turns people into patients needlessly by medicalizing everyday occurrences or by expanding disease definitions. For trainees, the terms ’false positive’ and ’misdiagnosis’ are commonly conflated with ’overdiagnosis.’ Although medical schools in Canada provide some instruction in the fundamentals of clinical epidemiology, overdiagnosis and overtreatment are typically ignored as objectives in undergraduate medical curriculum. For example, Toronto Notes is regarded as a comprehensive resource for students learning about medicine and preparing for the Medical Council of Canada Qualifying Examination (MCCQE), but the term ’overdiagnosis’ only appears three times in the textbook – only in connection with prostate-specific antigen screening. To increase students’ understanding of the concepts and demonstrate how to apply them in subsequent training and practice, this must be expanded and generalised, and instructional techniques must be developed.

Method The major goals of this workshop will be to pinpoint the key components of overdiagnosis education and the best pedagogical strategies for imparting to undergraduate medical students the ideas and issues at the heart of overdiagnosis. Medical educators with expertise in teaching overdiagnosis will participate in the workshop together with medical students. Broader examples will be sought for teaching undergraduate medical students about the concepts and issues surrounding overdiagnosis. A list of topics and themes in overdiagnosis and overtreatment will be compiled to inform a curriculum on the subject. The session will present current methods and get feedback on what may be the best techniques to teaching medical students about overdiagnosis and preventing them from overdiagnosing as future physicians.

Methods for disseminating information through problem-based learning or small-group discussions will be proposed. This will promote awareness and understanding of overdiagnosis and emphasize patient-centered care through collaborative decision-making.

Results A list of themes in overdiagnosis and overtreatment will be compiled in order to inform a curriculum on the subject for medical students. Also, methods for disseminating information through problem-based learning or small-group discussions will be proposed. This will support both the promotion of awareness and understanding of overdiagnosis and an emphasis on patient-centered care through collaborative decision-making. The major goals of this workshop will be to pinpoint the key components of overdiagnosis education and the best pedagogical strategies for imparting to undergraduate medical students the ideas and issues at the heart of overdiagnosis. The deliberations and input from this workshop will inform a paper on the topic that will be submitted to a medical education journal.

Conclusions The outcomes of this workshop can be used to enhance the CanMEDS 2025, which is currently being developed. CanMEDS is a framework that identifies and defines the skills doctors need to effectively address the patients‘ healthcare needs. Medical students will be better equipped to undertake good care, and identify substandard care if they are more aware of potential for overdiagnosis, and informed of the advantages and limitations of treatments and procedures. The deliberations and input from this workshop will inform a paper on the topic that will be submitted to a medical education journal.

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