Dear Sir
I recently led an “academic taster session” for a group of 14–15 years old school students during a day programme to improve access to higher education. Participants had been identified as having strong academic potential despite coming from schools that did not traditionally send students to university. I decided to see how they would fare when asked to make a diagnosis in a medical case.
To set the scene, I announced that a man sat in front of them, breathless and unable to speak. No other medical personnel were present, and they alone could work out the diagnosis and treat the patient. The clues they had were four envelopes, which contained an ECG, a chest X-ray, blood and sputum cultures, and the results of an arterial blood gas.
The students were given minimal background information: simple guides to interpreting the basics of each investigation; a brief medical glossary to explain terms such as acidosis, consolidation and tachycardia; a list of eleven possible diagnoses with expected corresponding findings in the clues; and the clues themselves. They were allowed to see each clue for up to five minutes, but could not see the same clue again once their time with it had elapsed.
Following initial trepidation, they quickly got to work in groups of four. The underlying diagnosis was an infective exacerbation of COPD, with the clues corresponding to this (e.g. an ECG showing sinus tachycardia and a hyper-expanded chest X-ray). Satisfaction was audible as pennies dropped around the room, students spotting what they were looking for in each “clue”.
Three out of the four groups arrived at the correct diagnosis, and the final group came close, but wrongly identified the case as acute respiratory distress syndrome due to misinterpretation of the chest X-ray. Despite no medical background, the students were able to suggest oxygen, antibiotics and inhalers as the treatment they would want to provide.
Diagnosing medical cases provides potent opportunities to raise scientific curiosity and develop problem-solving skills, even to those years away from considering starting medical school. I left the session impressed at the students’ abilities and reinvigorated in enthusiasm for teaching.
Declaration of interest: The author reports no declaration of interest.