Teaching Differential Diagnosis: Tool Box Techniques.

Differential diagnosis is one of the most challenging skills for a new clinician to learn. Typically, students are first exposed to the process of differential diagnosis in problem-based learning sessions. In general, techniques and tools to use in performing this important task are not universally or consistently taught, so successful clinicians learn this process largely from observing other more experienced clinicians. This article presents effective techniques and assignments that can be used to teach the process of differential diagnosis, enabling novice clinicians to become more accurate and proficient diagnosticians earlier on. Rubrics for evaluation and the theory behind these techniques are also provided.

Integrating the social determinants of health into two interprofessional courses: Findings from a pilot study.

Five colleges and universities in Upstate New York, United States, created the 'Route-90 Collaborative' to support faculty implementing the Institute of Medicine's (IOM) Framework for Educating Health Professionals to Address the Social Determinants of Health. The two courses described herein used a flipped classroom approach in which students from 14 different nations were responsible for facilitating individual classes. This descriptive study used an educational intervention in two interprofessional courses - reproductive health and global health - based on the IOM Framework into two courses. The evaluation used quantitative and open-ended text response data from students. Course evaluations indicated the students found the courses helped them to learn more about health issues and service delivery in various countries, expand their knowledge base on sociocultural and ecological influences on health care, and broaden their perspectives on various health topics so they will be able to provide higher quality healthcare. Although this is the first effort of our Collaborative to implement the Framework, given the student feedback, we believe implementing the Framework in various courses has the potential to enhance healthcare service delivery and reduce the negative impact of social determinants of health.

Filling out the forms: Health literacy among the uninsured.

This study addresses health literacy among patients at a free clinic in Syracuse, NY. Researchers conducted chart reviews of 600 patients and qualitative interviews with 22 patients and 7 providers. Most clinic patients had a high school, or higher, level education and no difficulty with reading comprehension. Nevertheless, a majority had at least some difficulty with comprehending and following through on health information. For many interviewees, the greatest difficulty was completing the required forms for entitlement programs. The findings demonstrate that low health literacy may occur even among well-educated patients and recommend that health literacy be assessed for all patients.

A description of patient characteristics, insurance status and travel distance at a free inner-city clinic.

This study was designed to investigate patient characteristics at Amaus Health Services at Cathedral, a free medical clinic in Syracuse, New York which provides interim primary health care to the underserved and uninsured populations in the downtown area of Syracuse. The mission of the clinic is to serve an inner-city population. This study found that the clinic sees equal numbers of men and women and half of the visits were for chronic disease management. Patients traveled from 33 different zip codes, most of which were outside of the intended service area. In addition, of the 278 visits, 50 clinic users reported having some form of insurance. These findings can help Amaus leadership direct volunteers and donations to enhance the services provided, and may assist other areas of the country to identify needs for enhanced access as changes occur in the health care system.