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Andrew S Parsons

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Andrew S. Parsons, MD, MPH (Educators, ’19) is a medical educator and Internal Medicine Hospitalist. Andrew currently holds a position as Assistant Professor of Medicine and Director of Clinical Skills at the University of Virginia School of Medicine where he also serves as Associate Program Director for the Internal Medicine Residency Program. Andrew’s areas of professional interest include clinical reasoning, remediation, and high-value care. Andrew can be followed on Twitter or reached via email.

Teaching Clinical Reasoning: How early is too early?

Although most medical schools have a pre-clerkship course dedicated to history taking, physical exam, and early patient exposure, clinical reasoning is rarely taught during the first years of medical school. Educators routinely wait until the more clinically focused clerkship to introduce and foster these skills. A recent national survey of clerkship directors found that most students enter clerkship with a “poor to fair” knowledge of clinical reasoning concepts. As a result, early clerkship students are left to merely observe the complex cognitive processes of more experienced clinicians that result in diagnostic and management decisions. Questions such as “How did you get to that?,” “How did you process all of that information so quickly?,” and “How did you know which questions to ask?” are common.

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