SHM Converge Scientific Abstract ePoster Gallery-Evaluating for Diagnostic Errors and Providing Clinical Reasoning Feedback for Night Float Medicine Residents

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This Northwestern Medicine project studied diagnostic errors and clinical reasoning feedback for internal medicine night float residents. The authors note two main problems: diagnostic reasoning errors are common but hard to detect, and feedback on reasoning is often limited or absent. They proposed using night float admission transitions as a practical opportunity to identify diagnostic changes and provide attending-level feedback.<br /><br />Residents on night float admitted patients overnight, and teaching attendings later reviewed selected cases. Feedback was sent back to residents after a delay, and residents were also encouraged to reflect on what they learned and use the electronic medical record to follow patient outcomes. The project tracked cases with diagnostic changes, errors, and harm over time, while also gathering resident feedback about the rotation.<br /><br />A survey completed by 26 residents (32 responses total) showed strong interest in feedback: 85% reported checking the chart the next day to see what changes were made, but only 1% reported receiving direct feedback from the day team. Residents said more frequent and timely feedback was highly valued and requested. The survey also captured reflections and other logistical concerns, which were shared with program leadership.<br /><br />The authors conclude that night float admissions offer a useful setting for studying diagnostic errors and supporting resident learning. They suggest that their feedback-and-reflection model could become one part of a broader, longitudinal program to assess and improve clinical reasoning in internal medicine residency.

Asset Subtitle

Abhinav Appukutty

Meta Tag

Author List Abhinav Appukutty, Bruce Henschen, Gopi J. Astik, Jane S. Kim, Luke Favia, Siew May Wang

Category Innovations

Concept Diagnostic Error

Concept Clinical Reasoning Breakdown

Concept Clinical Reasoning Feedback

Concept Night Float Residency

Concept Care Transition

Distinguished Non-Finalist

Presenter Organization Northwestern University, Feinberg School of Medicine

Presenting Author Abhinav Appukutty

Track Education

Keywords

diagnostic errors

clinical reasoning

night float

internal medicine residency

resident feedback

attending review

feedback model

diagnostic changes

patient outcomes

medical education

Diagnostic Error

Clinical Reasoning Breakdown

Clinical Reasoning Feedback

Night Float Residency

Care Transition