Teaching critical decision-making skills to students concerning patients with acute abdominal pain

Abstract

The clinical performance of junior hospital staff concerning the management of patients with acute abdominal pain, may be enhanced by placing greater emphasis on teaching clinical decision-making skills during the pre-intern year. Final year medical students at the Royal Prince Alfred Hospital (RPAH) took part in a teaching session where groups of 6–8 rotated through six stations, each structured to present a critical management problem concerning a patient with acute abdominal pain. Students, guided by a tutor, spent 25 minutes at each station, working through the sequence of data acquisition and data analysis before making a management decision. To assess the educational value of the programme, the study group completed a sequence of pre-test, structured teaching and post-test over a period of 2 weeks. Their multiple choice question (MCQ) performance was compared with a control group from a different campus who also did the pre-and post-test but without the teaching. The study group (n = 38) significantly (p < 0.001) improved their MCQ mark from a pre-test mean 68% (SD 8) to 74% (SD 6) following the teaching. The performance of the control group (n = 25), with no teaching, did not change significantly (p = 0.5) between pre-test (mean 66% SD 13) and post-test (mean 68% SD 6). The method appears an effective way to teach critical decision-making skills to medical students. Students regarded the innovation as educationally more effective than traditional teaching methods.