Evaluation of the effect of a new clinical reasoning curriculum in a pre-clerkship clinical skills course

Perspectives on Medical Education

article

Kelekar, Arati¹  Afonso, Nelia¹ 

[1] Oakland University William Beaumont School of Medicine;Department of Internal Medicine, Beaumont Health System, Royal Oak

关键词: Clinical reasoning;    Clinical skills;    Program evaluation;    Undergraduate medical education;   

DOI  :  10.1007/s40037-020-00566-4

学科分类：医学（综合）

来源: Bohn Stafleu van Loghum B.V.

【 摘 要 】

Introduction Clinical reasoning is often not explicitly taught to novice medical students. Pre-clerkship clinical skills courses are an ideal venue to teach the clinical reasoning process. The aim of the study was to evaluate the impact of a preclinical clinical reasoning curriculum through an end-of-semester objective structured clinical examination. Methods This study was conducted through our longitudinal clinical skills course. Second year medical (M2) students who received the clinical reasoning curriculum in 2018 formed the study cohort. M2 students from the previous year, who did not have the clinical reasoning curriculum, formed the comparison cohort. Several modalities were used to teach clinical reasoning including whole case approach, serial cue approach, self-explanation of pathophysiological mechanisms and comparison of closely related diagnoses. The students interviewed a standardized patient and documented the history along with three likely diagnoses. Results Students in the study cohort achieved higher scores on differential diagnosis (1.98 vs. 1.64 in the comparison cohort, p  0.05). Discussion Our study confirms that the introduction of clinical reasoning in a pre-clerkship clinical skills curriculum increases students’ ability to select relevant symptoms and provides them with a roadmap for expanding their differential diagnoses.

【 授权许可】

CC BY