Educational benefits of blinding students to information acquired and management plans generated by other physicians

At our university, Internal Medicine clerks are members of a team responsib le for the care of patients hospitalized on a teaching ward. Clerks first e ncounter their patients after the latter have been fully worked up by other physicians who have examined them and initiated investigations and managem ent. Clerks are thus deprived of the opportunity to practice information ac quisition, hypothesis generation and problem solving. We therefore undertoo k a 'blinding' initiative wherein each clerk was required to work up at lea st one hospitalized patient per week without access to the patient chart an d without knowledge of information acquired and hypotheses generated by oth er physicians. Weekly data collection during the g-week experiment with 40 clinical clerks revealed that work up of 'blinded' patients was more time-c onsuming and more difficult than work up of unblinded patients. Clerks were appreciative of the educational value of blinding. Teaching faculty felt c lerk 'blinding' to be a practical approach to approximating the true conduc t of medical practice and as such was useful for student learning.