Discovery based learning is a technique for seminars where you have 1/2 to 1 hour with a small group of medical students or clerks/JURSI's. It is very useful for filling in gaps in the student's knowledge and through a series of questions helping them make connections between memorized knowledge and clinical reasoning. By combining factual recall and higher order thinking answers to the preceptors questions, students increase their pattern recognition abilities. The following guide will help you use the technique in this type of session.

Methodology	Example
1. Identify the learning gap	Preceptor: What would you like to learn more about today? Students: The hormones involved in menopause
2. Review current knowledge and fill in any gaps. Students may bring memory aides or texts with them.	Preceptor: If Mrs. A comes into your office saying she thinks she is entering menopause, what symptoms might you expect her to be exhibiting? Students: (List symptoms) Preceptor: What about sexual issues, could she be experiencing any difficulties in that area? Students:(List) Preceptor: Very good you thought about most symptoms but she might also be experiencing (fills in gaps)
3. Review previous knowledge and fill in any gaps	Preceptor: Last week we looked at Menarche, what hormones were involved in that stage of development? Students: (List) Preceptor: What about the pituitary gland, what role does it play? Students: (Response) Preceptor: Good, you seem to remember the hormones well.
4. Facilitate making the connection between previously learned knowledge and new knowledge	Preceptor: So the hormones that begin the process of fertility, how might they influence the cessation of fertility? Students: (respond) Preceptor: What about the adrenal glands, what hormones are involved there? Students: (respond) Preceptor: Earlier Mariah mentioned some women report fuzzy thinking as one of the symptoms, why do you think that might be occurring. Students: (no response) Preceptor: How might sleep disruption effect thinking? etc. etc.
5. Facilitate clinical reasoning	Preceptor: So Mrs. A comes to you with symptoms caused by changes in hormone levels during menopause. How might you treat her? Students: (discussion) Preceptor: What about osteoporosis, what information does she need about preventing that? Students: (respond) etc.
5. Reinforce new knowledge	Preceptor: Today we looked at how the hormones produced by (list) influence menopause. When you go home, I'd like you to create a memory aide to assist you to remember what you learned today.

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