Introducing TOCSE: A tool to bridge didactic learning to clinical application (Part 1)


Target-Oriented Clinical Skill Enhancement (TOCSE)

To connect didactic learning to clinical application is a challenge both for the teachers and students. The dilemma starts from-- at what level must clinical learning be introduced to medical students? Should one come after another or be introduced at the same time? Nonetheless, the decision to do is critical.

Target-Oriented Clinical Skill Enhancement (TOCSE) is a teaching and learning tool that brings about the integration of basic medical sciences, such as anatomy, physiology, pathology, microbiology, and pharmacology at the clinical level. The uniqueness of the approach is:

  • The primary goal is immediate relief of chief complaint to make the patient comfortable.
  • Risk factors for the disease is identified first.
  • Pathophysiology of the chief complaint is defined next.
  • Primary disease and other diseases, if any, come last.
  • Bottomline, all identified abnormalities in the patient will be prioritized and targeted to be resolved.

TOCSE can be introduced with initial application at the second-year level. It is useful in the preparation of 3th year medical students for their 4th year tasks, foremost is writing progress notes. TOCSE table depicts a clear account of the patient’s clinical course which makes writing of discharge summary easy. Overall, TOCSE provides the following advantages and outcomes for an enjoyable teaching and learning experiences:

  • Concise diagnosis and management plans is formulated based on specific data in the history and physical examination.
  • Unnecessary work-up is avoided.
  • Logical daily assessment of patient is achieved.
  • Grading of students/trainees at any level is made easy.

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