Medical Decision Making for First-Year Medical Students

At Northwestern University in the fall of 2016 and the spring of 2017, I led a small group for first-year medical students as part of the Medical Decision Making course. I had 3 different groups of 10-12 students, each for 5 sessions on average every other week (then instructors would rotate groups). Topics included Diagnostics, Advanced Decision Making, Case Control and Cohorts, Risk Harm and Association, Prognosis, Screening, Threshold Actions, Clinical Prediction Rules, Decision Analysis, Cost Effective Analysis, Guidelines & Policy. I tried to include current clinical examples from my experiences with patients on diagnosis of food allergies (sensitivity and specificty of testing), management of asthma, cost effective workup of chronic urticaria, etc.

Here is an example of a small group discussion guide.

Learner Evaluations

2016-2017 Northwestern University

My MDM small group leader was effective (3 trimesters combined)

Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	N	Mean
0	0	2	16	9	27	4.3
0%	0%	7%	59%	33%

Class Average

Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	N	Mean
4	12	47	182	228	473	4.3
0.01%	0.03%	0.1%	38.5%	48.2%

“Dr. Feldman has made MDM small groups extremely interactive, and I feel as though I really learn the material both by preparing for these sessions and due to his teaching/review of concepts.”
“Dr. Feldman was an excellent MDM leader; he provided examples of times he used MDM principles in treating actual patients, and did a great job of explaining principles which the group didn’t understand.”
“Dr. Feldman does a great job in guiding our group through the assignment, emphasizing the important aspects and relating it to what is clinically relevant in reality.”
“Dr. Feldman was great about incorporating examples from his daily clinical routine into the MDM worksheets. I think that our group got a really unique insight into how these MDM principles factor into clinical decisions through Dr. Feldman’s examples and experiences.”
“Nicely done! Dr. Feldman knew his stuff very well.”
“Dr. Feldman was an amazing MDM group leader – keep him teaching this as long as possible! He engaged all group members, had clear expectations, explained all the material clearly, and helped us bring clinical reasoning from abstract principles to practical, real-world applications.”
“Dr. Feldman was a great leader of our MDM small group. He was consistently prepared for small group, and helped guide our group in what major takeaways we should be holding onto from each paper and small group session. He also always offered to stay after to take questions or help us with anything else we needed even if it did not pertain to the paper review assigned for that session. Dr. Feldman–Great work! Keep it up! I hope to work with you again in the future.”
“I liked how the tutor tried to instill clinical relevance to the lectures!”
“Dr. Feldman was a fantastic MDM leader, principally because beyond ensuring we understood the core MDM concepts and application to assigned paper, he shared his own clinical anecdotes that brought the course concepts to live. This allowed him to emphasize the importance and utility of these concepts and I think greatly aided my engagement with the material.”
“Dr. Feldman was an outstanding small group leader. He made sure we knew how to perform MDMskills and included the relevance to real life”