The burden of suffering, cost, and waste related to diagnostic error is an urgent public health issue in the United States and abroad. From 2018 to 2020, it was identified as the number 1 patient safety challenge,1 well after publication of the report Improving Diagnosis in Health Care, which called for major initiatives to improve diagnostic safety and quality.2 In addition to studies that have clarified the magnitude and importance of the problem,3,4 an increasingly robust understanding has developed of the factors that lead to diagnostic error, including system, cognitive, and contextual factors.5-7
A promising approach to improve diagnosis in practice is to focus on improving diagnosis education. Research studies over the past two decades have shown how diagnostic errors can be prevented or mitigated, and these lessons should become part of healthcare professionals’ education and training. While individual, professional, contextual, patient, and health system factors make diagnostic error a challenge to address, health professions education is a common experience for all healthcare professionals and is foundational in improving diagnosis.8
Although diagnostic competency is an important outcome for health profession education programs,9 the approach to teaching the requisite knowledge, skills, and attitudes for diagnosis varies in amount, content, and quality within and across professions.10-12 Much learning about diagnosis has occurred in a relatively tacit, rather than explicit, manner, and diagnosis-specific curricula that would address this need are lacking.
Substantial progress is being made in recognizing the need for diagnostic excellence,13 and improving diagnosis education will be an essential requirement to achieve this goal. This brief will highlight the current state of diagnosis education, including gaps; describe innovations with high potential for wider impact; identify key competencies needed to improve diagnostic performance; and describe next steps to ensure progress.
For clarity, we define health professions education broadly as any program preparing individuals for careers in healthcare. We aim to be inclusive across the continuum from early training programs (e.g., baccalaureate nursing programs and undergraduate medical education) to efforts that ensure continuing competence for practicing clinicians.
