|Year : 2017 | Volume
| Issue : 6 | Page : 611-612
How to conduct clinicopathological conference
Vishnu Sharma Moleyar
Department of Respiratory Medicine, A. J. Institute of Medical Sciences, Mangalore, Karnataka, India
|Date of Web Publication||17-Jan-2018|
Dr. Vishnu Sharma Moleyar
Department of Respiratory Medicine, A. J. Institute of Medical Sciences, Mangalore - 575 004, Karnataka
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Moleyar VS. How to conduct clinicopathological conference. Med J DY Patil Univ 2017;10:611-2
Clinicopathological conference (CPC) is a case-based method of learning medicine by problem-solving approach. CPC has been in practice for more than 100 years now. The idea was first practiced in Boston, in 1900 by a Harvard internist, Dr. Richard C. Cabot who practiced this as an informal discussion session in his private office. Dr. Cabot incepted this from a resident, who had received the idea from a roommate, who was a law student.
A well-chosen CPC is a powerful and dynamic teaching tool that offers clinical-pathologic correlation and competence of clinicians. The old saying, “If you do not think of it, you will never diagnose it” applies to the good clinical skills practice demonstrated in CPC. CPC provides an effective and regular educational media of collaborative learning for the inter-disciplinary exchange of knowledge among the faculty members of an institution. It also gives an opportunity to new teaching staff in the institution to experience an in-house practice of presenting the clinical cases which can readily be reproduced as a case report for publication.
The main objective of CPC is to emphasize on measured, logical progression from a patient's presentation to a narrowed differential diagnoses rather than focusing on a final diagnosis. Steps in CPC  has been described in succeeding paragraphs.
| Steps in Clinico Pathological Conference|| |
Selecting a case
Cases that have an unusual presentation of common diagnosis or typical presentation of unusual diagnosis make a good case for CPC presentation. The case for CPC should have the element of relevance, solvability, and discussability. Discriminating information must be available to allow thoughtful, logical discussion and consideration of differential diagnoses.
Preparing and presenting the case
The presenter will present history, physical examination, and all the relevant investigations, giving the results of those diagnostic tools. Diagnostic studies obtained are presented in the order in which it was collected. It may be appropriate to withhold a confirmatory test obtained as long as the case is solvable based on the other information presented.
Discussing the case
Moderator or discussant discusses the case. He will analyze and interpret the data provided by the presenter. He evaluates the case summarizing the salient features and relating these features to a list of differential diagnoses in his opinion. Contribution from the audience is invited by the moderator to add to the list of provisional diagnoses. Alternatively, the discussant may summarize the salient features about the case and invite the differential diagnosis from the audience. Then, he will discuss the case and differential diagnoses.
Presenting the ultimate diagnosis
At the end, the presenter will give the final diagnosis and factors involved in the final diagnosis. He will present the details of the management of the case.
At the end, a brief discussion of final diagnosis and management should be presented. Presenters in CPC are advised to restrain from lecturing the audience. This is important because the audience come from various disciplines and minor details of a subject are not relevant to them.
Multiple speakers can be involved in one case presentation. At the end, audience are invited for question answer session and share their views and expertise.
Another form of CPC is based on postmortem histology where the diagnosis was unclear ante mortem. The clinical discussant is provided all records available, and an attempt to establish a clinicopathologic correlation is made. This may also help identify some unrecognized causes of mortality in a given setting/geography.
| Modified Clinico Pathological Conference|| |
In this format of CPC, presenter and discussant is usually the same person or persons from the same department. Discussant here has prior information of ultimate diagnosis and outcome of the case to be presented. A contribution from the audience is invited by the presenter to add to the list of provisional diagnoses that has been proposed by the presenter. Alternatively, he may give the salient features about the case and invite the differential diagnosis from the audience. Later the presenter will give the detail of course of management and factors involved in the final diagnosis.
| Modified Clinico Pathological Conference- Interactive Case Discussion|| |
This is presented by a single person. A case is selected with specific predefined learning objectives. Differential diagnosis and approach discussed after each step. The audience participates in each step of discussion by way of an electronic voting system for MCQS. Each MCQ is discussed by the presenter. At the end diagnosis and management is briefly discussed.
Skilled presentation and discussion with a good deal of audience participation and their thought provocation is essential to make CPC effective.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Fred HL, Buja ML, Willerson JT. A call for CPC. Circulation 1995;91:2283.
McGee DL, Kowalenko T. Preparing and presenting an emergency clinical pathologic case conference. J Acad Emerg Med 2005;9:39.
Hassan S. About clinicopathological conference and its' practice in the school of medical sciences, USM. Malays J Med Sci 2006;13:7-10.