The design of the Chief Concern Course (CCC) takes a whole-task approach to teaching the complex skill of clinical reasoning to first-year medical students. The curriculum guides the students through increasingly complex cases and emphasizes prompt feedback on the performance of learning tasks, just-in-time information and resources, and opportunities to practice recurring procedures until they become automatic.

Each case begins with a “chief concern,” a patient’s main reason for seeking care. Cases horizontally integrate content from students’ science courses, but discourage overly compartmentalized thinking by deliberately “crossing” organ systems. Students learn an approach to thinking about clinical problems at a time when their content knowledge is just forming, rather than focusing on rote memorization of specific diseases.

The CCC encourages novice students to engage in largely analytic thinking while developing their skills surrounding how to interpret a patient’s symptoms in relation to established patterns of disease or hypothesis testing. The “inverted pyramid” model represents an effective clinical reasoning process, guiding students’ visualization and understanding of patient data, leading to a diagnosis and informing a plan of action.