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Introduction Developing the clinical reasoning skills necessary to becoming an astute diagnostician is essential for medical students. While some medical schools offer longitudinal opportunities for students to practice clinical reasoning during the preclinical curriculum, there remains a paucity of literature fully describing what that curriculum looks like. As a result, medical educators struggle to know what an effective clinical reasoning curriculum should look like, how it should be delivered, how it should be assessed, or what faculty development is necessary to be successful. We present our Introduction to Clinical Reasoning course that is offered throughout the preclinical curriculum of the Uniformed Services University of the Health Sciences. The course introduces clinical reasoning through interactive lectures and 28 case-based small group activities over 15 months. The curriculum is grounded in script theory with a focus on diagnostic reasoning. Specific emphasis is placed on building the student's semantic competence, constructing problem lists, comparing and contrasting similar diagnoses, constructing a summary statement, and formulating a prioritized differential diagnosis the student can defend. Several complementary methods of assessment are utilized across the curriculum. These include assessments of participation, knowledge, and application. The course leverages clinical faculty, graduate medical education trainees, and senior medical students as small group facilitators. Feedback from students and faculty consistently identifies the course as a highly effective and engaging way to teach clinical reasoning. Conclusion Our Introduction to Clinical Reasoning course offers students repeated exposure to well-selected cases to promote their development of clinical reasoning. The course is an example of how clinical reasoning can be taught across the preclinical curriculum without extensive faculty training in medical education or clinical reasoning theory. The course can be adapted into different instructional formats to cover a variety of topics to provide the early learner with sequential exposure and practice in diagnostic reasoning. [ABSTRACT FROM AUTHOR]

Objective: To determine the quality of published rheumatology‐focused continuing professional development (CPD) for primary care clinicians (PCCs) for improving the care of patients with rheumatic diseases. Methods: The authors conducted a systematic review of CPD focused on rheumatology topics for PCCs. A librarian systematically searched PubMed, Embase, Web of Science, ERIC, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Sinico. Studies were limited to those conducted in North America after 1993. An extraction form that included the Medical Education Research Study Quality Instrument and the Kirkpatrick levels of learning outcomes was created through an iterative process and applied to the included articles. Results: In total, 725 articles were retrieved, of which 9 were included. Results showed that CPD was directed more at noninflammatory arthritis than inflammatory arthritis. Autoimmune diseases were underrepresented; 4 studies discussed rheumatoid arthritis, and 1 study examined rheumatologic topics broadly. Newer research tended to include multimodal approaches that combined didactic and active learning strategies, showing an evolution toward more active learning. Although online learning is increasingly popular, interventions were predominantly face‐to‐face, with only a single example of e‐learning. Studies were predominantly of moderate quality. Conclusion: Published studies of rheumatology‐focused CPD are moving toward more interactive teaching modalities and are typically conducted in person, although virtual options for rheumatology‐focused CPD should be explored to improve access to CPD. Autoimmune disease is an uncommon topic in CPD and represents an area for future expansion. Efficacy was difficult to assess given that most of the studies assessed for learner satisfaction, knowledge acquisition, or behavior change, whereas only 1 study focused on patient outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Nearly half of all pregnancies in the USA are unintended with a relatively higher proportion occurring in military populations, which can have a large impact on military readiness. Military and civilian internal medicine residency programs do not place an emphasis on contraception in the primary care setting. This intervention sought to elucidate the perceptions of contraception in an internal medicine primary care setting in a military residency and improve confidence in contraceptive counseling and prescribing.Material and Methods: Residents at a military internal residency program were given an hour-long didactic presentation on contraception that was followed 5 weeks later by the implementation of a pocket card for point of care use with key information from the presentation. Residents became certified in the placement and removal of the etonogestrel implant. Pre- and post-intervention surveys were administered to assess for changes in attitudes and confidence in prescribing and counseling. This project was determined to be a quality improvement project by the IRB board of the home institution.Results: Forty-two of 75 (56%) residents responded initially and 40 of 75 (53%) responded after the intervention. There was a significant improvement in resident attitudes towards the applicability of contraception training in internal medicine (p = 0.03) as well as acquiring the skill of etonogestrel implant placement (p = 0.001). There was a trend towards significance in confidence in prescribing oral contraception (p = 0.053). There was no change in residents' confidence in counseling on oral contraception (p = 0.45).Conclusion: A change in the contraception curriculum led to improved residents' skills in etonogestrel placement, and attitudes regarding the applicability of training in contraception to internal medicine, but did not significantly improve confidence in contraceptive counseling. These results suggest that internal medicine residencies should focus on teaching contraception to improve the attitudes in future internists who will need to address contraception in the military population. Future studies could include assessing physician preparedness for addressing contraception during general medical officer tours. [ABSTRACT FROM AUTHOR]