Implementation of a clinical reasoning curriculum for clerkship-level medical students: a pseudo-randomized and controlled study. Diagnosis (Berl) 2019 Jun 26;6(2):165-172
Date
03/29/2019Pubmed ID
30920952DOI
10.1515/dx-2018-0063Scopus ID
2-s2.0-85089868573 (requires institutional sign-in at Scopus site) 10 CitationsAbstract
Background The National Academies of Sciences report Improving Diagnosis in Healthcare highlighted the need for better training in medical decision-making, but most medical schools lack formal education in clinical reasoning. Methods We conducted a pseudo-randomized and controlled study to evaluate the impact of a clinical reasoning curriculum in an internal medicine clerkship. Students in the intervention group completed six interactive online modules focused on reasoning concepts and a skills-based workshop. We assessed the impact of the curriculum on clinical reasoning knowledge and skills and perception of education by evaluating: (1) performance on a clinical reasoning concept quiz, (2) demonstration of reasoning in hospital admission notes, and (3) awareness of attending physician utilization of clinical reasoning concepts. Results Students in the intervention group demonstrated superior performance on the clinical reasoning knowledge quiz (67% vs. 54%, p < 0.001). Students in the intervention group demonstrated superior written reasoning skills in the data synthesis (2.3 vs. 2.0, p = 0.02) and diagnostic reasoning (2.2 vs. 1.9, p = 0.02) portions of their admission notes, and reported more discussion of clinical reasoning by their attending physicians. Conclusions Exposure to a clinical reasoning curriculum was associated with superior reasoning knowledge and superior written demonstration of clinical reasoning skills by third-year medical students on an internal medicine clerkship.
Author List
Bonifacino E, Follansbee WP, Farkas AH, Jeong K, McNeil MA, DiNardo DJAuthor
Amy H. Farkas MD, MS Associate Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Clinical ClerkshipClinical Decision-Making
Curriculum
Education, Medical, Undergraduate
Educational Measurement
Health Plan Implementation
Humans
Internal Medicine
Students, Medical
Writing
