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What is the role of the clinical “pearl”?

      Medicine is undergoing rapid change. Science has altered the way in which we view disease, diagnostic procedures, and therapeutic options. Transmitting this information to practicing physicians, students, and residents remains one of the challenges facing medical educators. Typically, there are two methods of communicating these options, and these often appear to be in conflict. The clinical pearl is an often-anecdotal method of relaying information. Pearls offer clues about the patient at hand and are aphorisms worded to imply something absolute. The evidence-based medicine (EBM) approach has emerged as an alternative method to transmit information that is not yet common knowledge. The use of the EBM model depends on valid scientific studies. Yet applying such evidence to clinical practice still hinges on the sound judgment of clinicians. Typically, physicians and medical students rely primarily on only one heuristic model for their own education and decision making. Some critics consider the use of pearls and anecdotes to be a teaching method somewhat lacking in rigor and thus unscientific; others, however, consider EBM unnecessarily rigid and often impractical (
      • Paauw D.S.
      Did we learn evidence-based medicine in medical school? Some common medical mythology.
      ,
      • Maynard A.
      Evidence-based medicine an incomplete method for informing treatment choices.
      ). It would seem that the practice of medicine is best suited by an amalgam of these two educational strategies, and indeed such a method may make medicine more enjoyable.
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