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Basic diagnostic skills modules

First a brief word about using this Web course. You should begin with this introduction and proceed to the Modules beginning with Module 1, then Module 2 etc. Take the quizzes as they come up and answer the questions yourself before checking your answer with the one supplied. Every module and quiz contains instructions. Read the instructions carefully.

We (the department of Oral and Maxillofacial Pathology) are here to be resources for you. If you have any questions, please ask us. Your primary resource is your text: Oral and Maxillofacial Pathology by Neville, Damm, Allen and Bouquot. You are encouraged to refer to this text often and in all circumstances in this course. You may, of course, refer to other texts and journal articles as needed.

Basic principle of the course

Remember the most important principle of this course: You are learning a skill. Process is the most important product. Getting the correct answer is not the aim. We hope you enjoy this experience.

In these modules you will be building a framework of the basic skills you need to master in order to deal with patients who present with problems. Many patients will come into your office with a problem they want you to deal with immediately. Some patients come in for general care or "check ups." Some of the skills emphasized in these modules help you focus on specific problems. Specific problems may lead to more general ones and you must always be on the alert for these kinds of connections. Most of the skills you will learn are applicable to all patients and circumstances. However, the frame of reference and the examples used in these modules will deal with specific problems.

Most patients you treat have at least one problem. Sometimes the problem is obvious and sometimes not. In any case it is your job to define the problem, devise a treatment plan, initiate treatment and follow up your treatment to make sure the patient gets better and evaluate your method of treatment. 

The skills you will develop fall into two basic categories: investigative skills and analytical skills.

Investigative skills

Investigative skills help you discover and name the problem or problems with which your patient presents. These skills include interrogatory (questioning) skills: how to ask your patient questions and how to follow up with other questions until you get the information you need. Descriptive skills allow you to see accurately what you are looking at and notice what is important about what you are seeing. Summative skills allow you to take in a large amount of information and weed out exactly what you need then decide what information is missing. Summative skills also aid you in making a brief summary statement of the problem that says what you need to say and no more.

Analytical skills

Analytical skills help you to take the large amount of information you gather, compare it to a known body of information on diseases (causes of problems) and decide on the most probable cause of your patient's problem. With good analytical skills you will know when you don't have enough information to make a decision and what you have to do to get the information you need. Deciding what to do to treat your patient once you know what is causing their problem also takes analytical skills.. You also use analytical skills to follow up your treatment and learn from the results.

Thus the modules that follow will give you a good start in developing both investigative and analytical skills that are basic skills you need to provide competent professional care for your patients.

Goal

The goal of this series of modules is to develop a set of basic diagnostic skills with which you can discover, analyze, diagnose, treat and follow up patient problems.

Objectives

  1. Elicit and interpret a patient's chief complaint.
  2. Describe and interpret oral soft tissue and hard tissue lesions in terms of location, color and morphology as they appear on physical examination and on radiographs.
  3. Synthesize data from the chief complaint, history of the present illness, physical examination, medical and dental histories and other diagnostic tests to derive a pre-hypothesis statement of the patient's problem and an initial hypothesis list (differential diagnosis) for the patient's problem.
  4. Critically analyze data from texts and the literature and known information discovered from a patient to test (rule in or rule out) elements in the initial hypothesis list (differential diagnosis).
  5. Decide how to determine a final diagnosis from the elements in the final differential diagnosis list.
  6. Recommend treatment and follow-up for patients whose problems you have analyzed.

Virginia Commonwealth University
School of Dentistry
Department of Oral Diagnostic Sciences
Lyons Dental Building
520 North 12th Street
Richmond, Virginia 23298-0566
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