NEJM Healer Makes Teaching, Developing and Assessing the Essential Skill of Clinical Reasoning Easier

NEJM Healer offers learners a variety of realistic and immersive adult medicine cases involving core diseases across a range of specialties and difficulty levels. Learners experience how to most efficiently triage the patient, take a detailed history, perform a thorough physical exam, and evaluate lab and imaging results to help them build and narrow their differential diagnoses.

Learners are fully supported with access to documents that explain the key concepts, steps, and terminology in the clinical reasoning process, as well as an extensive library of detailed illness scripts and diagnostic schemas.

NEJM Healer graphically displays extensive reports with detailed feedback amounting to hours of input from an expert. Learners will see exactly how an expert identified a lead disease, including how a single finding affected the likelihood of different diseases on the differential.

Educators get access to standardized, unbiased assessment data, as well as a detailed view of students’ performance data and their own self-assessments and concordance data, which helps them track progress and identify learners in need of remediation.

Problems NEJM Healer Solves

Accurate clinical decision-making is at the center of modern patient care. Poor clinical reasoning contributes to diagnostic errors that affect millions of individuals and cause an estimated 40,000-80,000 deaths each year in the United States.

The development of clinical reasoning is a relatively new focus area in the changing field of medical education. While most programs are finding ways to include clinical reasoning in their curriculum, many lack a structured way of teaching or assessing it and providing the right balance of objective and subjective feedback. NEJM Healer addresses several of the key issues facing educators and learners alike.

Clinical reasoning is complex

Diagnostic reasoning is a complex multi-step, iterative process, dependent on a large body of knowledge.

Clinical reasoning is difficult to teach

By the time clinicians become educators, their own clinical reasoning process has become second nature. They may struggle to integrate the process into their curriculum, especially since there are few proven, standard methods for doing so.

Clinical reasoning is difficult to measure

Clinical reasoning has always been difficult to assess. Traditional assessment tools fail to assess clinical reasoning, leading to a significant gap in the ability to measure and improve learner performance in this area.

Faculty time and resources are strained

From academic and research responsibilities to administrative and clinical ones, educators have a lot on their already overflowing plate. It is very challenging to find the time to teach clinical reasoning in a personalized, engaging, and effective way or to assess it through direct observation or post-encounter presentations.

Clinical Reasoning Process

Teaching and assessing clinical reasoning is difficult, even for the experts

Regardless of whether you think of it as art or science, we now know that the clinical reasoning process is multi-step and iterative and that it can be taught and learned.

Clinical Reasoning Development Requires Deliberate Practice

Exposure to cases and clinical scenarios are essential to helping students develop their knowledge and reasoning, but we can’t rely on direct clinical experience alone.

We need new, safe, and appealing ways for learners to engage in deliberate practice and provide educators with objective data.

Rather than developing clinical reasoning through mere observation and repetition, with NEJM Healer, mastery is achieved through deliberate practice during each encounter, along with direct feedback from experts.

With this repeated, deliberate practice and built-in coaching from NEJM Healer, learners will improve performance and speed up the development of their clinical reasoning skills. Along the way, they will become more confident in their ability to apply the process to any patient case.

The Solution

NEJM Healer Empowers Learners to Think Like Clinical Experts

NEJM Healer offers an innovative approach to teaching and assessing clinical reasoning. Through a granular approach to diagnosis and extensive expert feedback, students gain deep insights into their abilities in multiple-component areas of the reasoning process to arrive at a holistic picture of their strengths and weaknesses.

NEJM Healer Demystifies Clinical Reasoning

With NEJM Healer, learners are able to measure and comprehend the different ingredients of clinical reasoning to a degree that even experts may find difficult to articulate. NEJM Healer aligns with current cognitive models and reinforces learning with a data-driven process that presents detailed feedback and expert rationales to the learner.

NEJM Healer Combines Knowledge and Reasoning

NEJM Healer brings expert-created, data-driven illness scripts and diagnostic schemas together with highly interactive patient cases, ensuring that learners combine clinical knowledge with critical thinking as they build their differential diagnosis.

NEJM Healer Compares Learners’ Performance to That of an Expert

Learners receive detailed feedback comparing their performance to an expert’s perspective for each virtual patient encounter. Learners can track their progress against key performance indicators over time, and educators can get a holistic picture across cohorts to gauge progress and identify students at risk.

NEJM Healer is Based on Gold-Standard Content

NEJM Healer is from NEJM Group, the world’s most trusted source for medical research and education. NEJM Group editors assembled expert clinicians and leaders in clinical reasoning to develop and curate the content library that drives the learning experience.

Dramatically Impact Your Ability to Teach and Assess Clinical Reasoning Skills

Whether you’re educating medical school students, physician assistants, or residents, NEJM Healer is the flexible solution that goes beyond a one-to-one simulation of the medical apprenticeship to help you reimagine the way you teach and assess clinical reasoning skills.

Nowhere but with NEJM Healer do you get the equivalent of volumes of knowledge, decades of cognitive research expertise, a multitude of cases, and untold hours of curriculum development and learner assessment, all in one place to help speed the coaching process and reduce your academic burdens.

Experience a Patient Encounter Yourself

Deliberate Practice for Developing Sound Clinical Reasoning and Achieving Diagnostic Excellence

TESTIMONIALS

Top Institutions Around the Globe Trust NEJM Healer

What makes NEJM Healer innovative is its approach to tap into the science of clinical problem solving (reasoning) through the use of illness scripts and by prompting users to consider how data contributes to the final diagnosis in clinical cases. This product can be of tremendous value to students as they prepare for real patient encounters.
Anthony A. Miller, M.Ed., PA-C (Emeritus) Distinguished Professor Division of Physician Assistant Studies
Shenandoah University
As an educator, the most exciting aspect of NEJM Healer for an educator is the objective data! Historically, clinical reasoning is assessed by an educator's gestalt... does the student "get it" or not? NEJM Healer breaks down the clinical reasoning process into well-defined steps that can be easily measured to help determine the strengths or deficits in the clinical reasoning process. This creates an incredible potential for remediating students with clinical reasoning difficulties.
Nicholas Duca, MD Assistant Professor of Medicine Clerkship Director for Internal Medicine
Penn State College of Medicine
NEJM healer is most exciting to me as a learning and assessment tool, providing unprecedented parameters and perspectives on learner growth and development. It fits perfectly within a competency-based medical education assessment for learning system.
Myles Nickolich, MD, Assistant Dean for Education in the Clinical Learning Environment, Penn State College of Medicine
Associate Program Director for the Penn State Cancer Institute Hematology-Oncology Fellowship Program

Frequently Asked Questions

How does NEJM Healer help educators develop clinical reasoning curriculum?

Educators can use NEJM Healer to create and supplement a curriculum in multiple ways. It provides a:

  • Wide range of cases covering core clinical presentations and common diseases
  • Glossary of terms and a thorough written introduction to clinical reasoning
  • Way to practice the discrete micro-skills that go into clinical reasoning
  • Wide selection of detailed illness scripts and diagnostic schemas that can be used in the lecture hall or accessed by students before, during, or after completing a case to help fill in key knowledge gaps
  • Format that can be assigned asynchronously to students or can be used in lectures, with expert feedback to guide the educator

Can NEJM Healer help educators assess learner performance?

NEJM Healer provides an excellent format for learners to engage in deliberate practice. In addition, its combination of objective and subjective assessment measures, deep performance data, and multiple levels of feedback make it a natural tool to augment existing forms of summative assessment and to offer remediation for learners with identified needs.

What kind of performance data are available for educators?

NEJM Healer improves the evaluation of the clinical reasoning process with a proprietary, quantitative, algorithmic assessment that provides formative and summary performance scoring and detailed feedback on the clinical reasoning process learners follow. NEJM Healer provides reporting on both learners’ performance and progress to help educators track individual learners and cohorts at each stage of a case and for the case as a whole. This reporting data presents educators with powerful insights into learners’ clinical reasoning profiles according to both objective and self-assessed measures. Learn More about assessment and feedback.

How can I use NEJM Healer in the classroom?

NEJM Healer can be used to support the formal instruction of clinical reasoning as part of a point-in-time assessment (such as an objective structured clinical examination or OSCE, or when starting or finishing a rotation), a focused course syllabus, or across the broader curriculum spanning pre-clinical and clinical learning. Faculty can work through cases with students in a live classroom setting.

How can I use NEJM Healer in my Residency Program?

NEJM Healer lets educators establish a baseline for each incoming resident’s clinical reasoning skill level and identify residents who need improvement. They can continue to use the application throughout a residency to quickly identify trainees who aren’t meeting critical thresholds for remediation and coaching.

How can I use NEJM asynchronously?

You can assign a range of cases in advance for students to do over a course, a year, or as they onboard and offboard from rotations. Educators can assign cases to the entire class and assess learners’ reasoning skills using robust performance data. They also can assign additional cases to learners as a way of ensuring exposure to certain clinical scenarios, or as remediation.

What is included with a NEJM Healer subscription?

Your institution’s subscription contains the following:

  • Access to all current cases and all new cases developed during the term of your subscription
  • An educator assignment center which allows faculty to assign each case to either the assessment or practice section of the database – providing you the opportunity to tailor the learning to your program’s needs while giving the learner independent deliberate practice opportunities
  • Program level reporting such as performance tracking and progress to help  educators  pinpoint areas of remediation for each learner
  • Individual Learner Reporting that shows the learner areas of discordance with the experts as well as detailed feedback and rationale for each step, helping the learner understand and improve their clinical reasoning skills
  • The Knowledge Center, which provides important tips and guides the learner through the illness script or diagnostic schema

How do I purchase NEJM Healer?

NEJM Healer is available for schools and hospitals to purchase for their students and residents. To learn more, you can complete this form here or email us at healersales@nejm.org.

Hundreds of diseases to consider
An overview of clinical reasoning and a glossary of key terms
100+ expert illness scripts to provide and support students’ clinical knowledge
Detailed assessment of clinical reasoning skills

Experience a Patient Encounter Yourself

Deliberate Practice for Developing Sound Clinical Reasoning and Achieving Diagnostic Excellence