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CLINICAL REVIEW: Ed Peile More to be learnt from the discussion than the diagnosis BMJ 2003; 326: 1136 [Full text]

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Don't undervalue training

David F. Levine   (27 May 2003)

Don't undervalue training 27 May 2003
David F. Levine, Consultant Physician West Cornwall Hospital TR18 2PF Send response to journal: Re: Don't undervalue training	Ed Peile rightly identifies some generic foci of learning but may be missing one key value of the debate. The whole point about the value of Mr. Hartle's contribution is that he could give it only because he survived. Many experienced clinicians stressed the need to rule out aortic dissection from the initial data and some rightly stuck to their guns and didn't misinterpret later laboratory data. This is the mark of the expert clinician who uses carefully built-up illness scripts to make accurate diagnoses more quickly and more often than those less expert. There were therefore some very pragmatic and specific learning points not mentioned. Essentially, can we learn from the experience of others and shorten our our path from beginner to expert? Ed Peile should also forget the old myths about 'training' being intrinsically lower in status than 'education'. Come and see some modern skills training with all its attendant cognitive and judgement elements. Pray tell me the difference between a puzzle and a problem in Mr. Hartle's case? Competing interests:   None declared