A Guide to Developing Clinical Reasoning Skills in Neurology: A Focus on Medical Students

MedEdPORTAL

Roy Strowd¹  Anthony Kwan²  Tiana Cruz³  Charlene Gamaldo⁴  Rachel Salas⁵ 

[1] 1 Wake Forest School of Medicine of Wake Forest Baptist Medical Center;2 State University of New York Downstate Medical Center College of Medicine;3 Johns Hopkins University School of Medicine;4 Johns Hopkins University School of Medicine;5 Johns Hopkins University School of Medicine;

关键词: Clinical Clerkship;    Case-Based Learning;    Neurology;    Clinical Reasoning;    Self-Directed Learning;    Peer-Mediated Learning;   

DOI  :  10.15766/mep_2374-8265.10163

来源: DOAJ

【 摘 要 】

Abstract Introduction Clinical reasoning is a fundamental skill in medicine. Teaching of this important skill spans much of formal medical training and encompasses both the acquisition of medical knowledge (i.e., content-oriented learning) and the integration of sufficient clinical experience (i.e., process-oriented learning). This course incorporates clinically relevant clerkship content to deliver a process-oriented (as opposed to content-oriented) approach to learning. Methods This course involves two 60-minute sessions distributed over the 4-week required Neurology Core Clerkship rotation at our institution. In Session 1, the instructor leads students in the generation of a framework for evaluating neurologic disease. Students are introduced to the concepts underlying clinical reasoning in neurology, including the process of lesion localization, development of categorization of the case, and differential diagnosis formation. In Session 2, students engage in a heavily peer-mediated, learner-centered approach to applying the concepts learned in Session 1 to clinical scenarios. Clinically relevant cases, either provided by the instructor or from student-driven clinical encounters, are used to apply the framework and build models for efficiently evaluating neurologic disease. Results Approximately 1 year following implementation, the course has been exceedingly well received. Student satisfaction has been high. The course has also not negatively impacted student performance in the clerkship. National Board of Medical Examiners Neurology Shelf Exam scores were not different in the year following implementation of the course, nor were there differences in mean rating of student clinical performance as assessed by faculty and resident clinical evaluations as observed in the years prior to and following institution of the course. Discussion Initial student feedback was largely positive and suggested the existing format was sufficient to meet the course objectives. Student participation with the noncompulsory clinical case vignettes has remained low, and additional incentives have been sought to encourage self-directed student participation. While course content is most relevant to neurology, the skills acquired are generalizable to all of medicine and are particularly applicable to the clinical clerkship.

【 授权许可】

Unknown