Purpose
Medical students’ clinical education is commonly supported by deliberate or voluntary use of electronic diagnostic reasoning tools (EDRTs). Patterns of EDRT usage during formative clinical training may have a lasting influence on their practice of medicine, signaling the need for a more robust understanding of EDRT integration in clinical education. In this study, the authors investigated culminating third-year medical students’ perceptions and use of EDRTs in multiple clinical settings and patient types, over a year of core clerkship rotations.
Methods
One hundred and forty-seven third-year medical students volunteered to participate in a survey on EDRT usage by patient age group, type of illness, and clinical setting. Perceptions of EDRTs in benefitting students’ clinical education experience, reducing diagnostic errors, and improving diagnostic reasoning capability were recorded.
Results
All 147 participants reported using EDRTs, largely via desktop computers (98%) and smartphones (38.6%). Institutionally subscribed tools, UpToDate and Epocrates, dominated student preferences. Although students used EDRTs across all patients, illnesses, and clinical settings, they used them most on inpatient services and least in psychiatry and surgery. Most students found EDRTs very helpful for generating differential diagnoses and confirming a final diagnosis, but only 36.3% found them very helpful in reducing errors.
Conclusion
Overall, third-year medical students view diagnostic reasoning tools favorably and use them extensively. Institutions can influence students’ use of EDRTs by providing focused and early training, easy access through availability of hardware and consistent internet connectivity, and carefully selected subscription to those online tools that offer the most frequently updated and highest quality educational information.