Original Publication
Open Access

Medical Skills in a Clinical Presentation-Based Curriculum: Approach to the Patient with Diarrhea

Published: June 18, 2015 | 10.15766/mep_2374-8265.10137

Included in this publication:

  • Instructor's Guide - Approach to the Patient with Diarrhea.doc
  • Approach to Diarrhea - Exam Room Guide.docx
  • Approach to Diarrhea.mp4
  • Approach to Diarrhea - Exam Room Outline.docx
  • Approach to Diarrhea - Turning Point Quiz.ppt
  • Dolores Pena - 58 yo Female with Diarrhea.doc
  • Approach to Diarrhea - Peer Observer Checklist.docx
  • Organization and Operation of the Medical Skills Course at PLFSOM.doc
  • The PLFSOM Standardized Patient Program.doc

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


Introduction: This module will guide clinical faculty as they organize and present a learning session for preclerkship medical students on the clinical work-up of a patient with diarrhea. During the session, students individually (or in pairs) work through the interview and perform the examination of a standardized patient presenting with diarrhea. After this encounter, students write a subjective, objective, assessment, and plan (SOAP) note, receive feedback from the standardized patient (and from their peer observer, if present) and debrief in a group discussion with a faculty member. Methods: Provided materials include a readiness assurance quiz, preparatory exam room guide and video, summary outline for use during the standardized patient encounter, a checklist to guide peer observer feedback, and a standardized patient case blueprint. These materials would be of interest to preclerkship clinical skills instructors who would like to teach a presentation-based, focused history and physical exam to their trainees. Methods: These materials were originally developed for the Medical Skills Course at the Texas Tech University Paul L. Foster School of Medicine (PLFSOM) in El Paso, Texas. Over the 5 years that we have used this case at PLFSOM, our first-year students have included the diagnosis of Crohn's disease in their top three diagnoses about 80% of the time. Discussion: Our conclusion is that the majority of pre-clerkship medical students are indeed able to perform a structured interview and exam of this complexity, use their findings to successfully navigate the scheme diagram, and assign a high likelihood to the correct disease mechanism and diagnosis.

Educational Objectives

By the end of this session, learners will be able to:

  1. Apply the principles of effective communication to facilitate relationship building, data-gathering, and patient education.
  2. Use focused questioning and physical examination to categorize diarrhea has either acute or chronic.
  3. Use questioning and findings to discriminate between an infectious and noninfectious cause for acute diarrhea.
  4. Use questioning and findings to discriminate between watery, inflammatory, and fatty diarrhea, if the patient has chronic diarrhea.
  5. Write a subjective, objective, assessment, and plan note that captures the important points of the history narrative, past history including pertinent negative and positive points, important physical exam findings and essential features of diagnostic reasoning, likely diagnoses, and plan.

Author Information

  • Gordon Woods, MD, MHPE: Texas Tech University Health Sciences Center School of Medicine

None to report.

None to report.


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Woods G. Medical skills in a clinical presentation-based curriculum: approach to the patient with diarrhea. MedEdPORTAL. 2015;11:10137. https://doi.org/10.15766/mep_2374-8265.10137