Original Publication
Open Access

Differential Diagnosis: Approaches and Pitfalls - A Pediatric Case-Based Session for 3rd Year Medical Students

Published: December 19, 2013 | 10.15766/mep_2374-8265.9640

Included in this publication:

  • Clinical Decision Making Facilitator Guide.doc
  • Clinical Decision Making Slides.pptx
  • Clinical Decision Making Cases.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.


This 90-minute session seeks to provide a systematic framework for medical students relatively new to the differential diagnosis process. Via a combined lecture/case-based approach, the session presents basic clinical reasoning concepts and specific heuristics to guide the differential process, followed by an opportunity to apply the tools to simulated pediatric cases. It also introduces the concept of cognitive biases and presents strategies to mitigate their effects. The session has been successfully used with third-year medical students during the first week of their pediatrics clerkship. However, with minor adaptation, a similar approach could be used at other levels of medical training or in other clinical settings. For over 4 years, this session has been given to third-year pediatric clerkship students at the George Washington University School of Medicine and Health Sciences during the first week of their pediatric clerkship at Children’s National Medical Center. Between 25 and 35 students typically participate in the session. Students are asked to provide feedback about teaching effectiveness, and the session has routinely been very well received, with average ratings of over 4.8 out of 5.

Educational Objectives

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

  1. Present an overview of the theoretical foundations and challenges of the differential diagnosis process.
  2. Provide a structured, systematic, adaptable approach to the differential diagnosis
  3. Describe the concept of cognitive biases and how they can lead to diagnostic errors.
  4. Describe the concept of a diagnostic time-out to help mitigate the potential effects of diagnostic errors.
  5. Practice their diagnostic skills on a set of representative pediatric cases.

Author Information

  • Zev Waldman, MD, MPP: HSC Pediatric Center
  • Mary Ottolini: George Washington University School of Medicine and Health Sciences

None to report.

None to report.


Waldman Z, Ottolini M. Differential diagnosis: approaches and pitfalls - a pediatric case-based session for 3rd year medical students. MedEdPORTAL. 2013;9:9640. https://doi.org/10.15766/mep_2374-8265.9640