The genealogy of teaching clinical reasoning and diagnostic skill: the GEL Study

Stephen W. Russell
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  • Associate Professor of Internal Medicine and Pediatrics, The University of Alabama at Birmingham, c/o UAB Medicine Leeds, 1141 Payton Way, Leeds, AL 35094, USA
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, Sanjay V. Desai, Paul O’Rourke, Neera Ahuja, Anand Patel, Christopher G. Myers
  • Department of Internal Medicine, Johns Hopkins University Carey Business School – Baltimore Campus, Baltimore, MD, USA
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, Donna Zulman, Heather F. Sateia, Gail V. Berkenblit, Erica N. Johnson and Brian T. Garibaldi
  • Department of Pulmonary and Critical Care Medicine, Johns Hopkins Hospital and Health System, Baltimore, MD, USA
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The genealogy of graduate medical education in America begins at the bedside. However, today’s graduate medical trainees work in a training environment that is vastly different from medical training a century ago. The goal of the Graduate Medical Education Laboratory (GEL) Study, supported by the American Medical Association’s (AMA) “Reimagining Residency” initiative, is to determine the factors in the training environment that most contribute to resident well-being and developing diagnostic skills. We believe that increasing time at the bedside will improve clinical skill, increase professional fulfillment, and reduce workplace burnout. Our graduate medical education laboratory will test these ideas to understand which interventions can be shared among all training programs. Through the GEL Study, we aim to ensure resident readiness for practice as we understand, then optimize, the learning environment for trainees and staff.

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Diagnosis aims at answering the question how diagnosis determines the quality of medical care. It focuses on how diagnosis can be advanced, how it is taught, and how and why it can fail, leading to diagnostic errors. The journal welcomes both fundamental and applied works, improvement initiatives, opinions, and debates to encourage new thinking on improving this critical aspect of healthcare quality.