A required course in decision-making for preclinical medical students.

Objectives, methods of instruction, and evaluation of a preclinical course in decision-making are described in this article. One set of objectives that related to learning to read and write clinical algorithms was taught by having students read a clinical algorithm about a problem, solve a patient management problem about the problem, and write an algorithm. A second set of objectives that related to learning clinical decision analysis was taught by solving problems and discussing them. Three methods used to evaluate three classes showed the following results: large increases in taped interview problem (TIP) scores after learning algorithms, high mean scores on a final examination that tested all course objectives, and high voluntary class attendance. It is concluded that preclinical medical students can be taught cognitive decision-making skills, that the TIP is a promising tool for measuring such skills, and that careful monitoring of a course in clinical decision-making may provide valuable information regarding learning and teaching technical clinical management.