A “hidden curriculum” pervasive in the academic environment encourages medical students to search for zebras through extensive (and often unnecessary) diagnostic workups. Because restraint is often discouraged, students adopt the belief that faculty expect an exhaustive diagnostic approach, and feel that they need to demonstrate their knowledge, thoroughness and curiosity through test ordering. Students can overcome this practice by articulating why they chose not to order a specific test. This, combined with a shift towards ‘celebrating restraint’ by faculty can help to combat this pervasive practice in medical training.
Sources:
Detsky AS, et al. A new model for medical education: celebrating restraint. JAMA. 2012 Oct 3;308(13):1329-30. PMID: 23032547.