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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Schmidt, Henk G. Mamede, Sílvia |
| Description | Country affiliation: Netherlands Author Affiliation: Schmidt HG ( Department of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands.); Mamede S ( Institute of Medical Education Research Rotterdam, Erasmus Medical Centre, Rotterdam, The Netherlands.) |
| Abstract | CONTEXT: The development of clinical reasoning (CR) in students has traditionally been left to clinical rotations, which, however, often offer limited practice and suboptimal supervision. Medical schools begin to address these limitations by organising pre-clinical CR courses. The purpose of this paper is to review the variety of approaches employed in the teaching of CR and to present a proposal to improve these practices. METHODS: We conducted a narrative review of the literature on teaching CR. To that end, we searched PubMed and Web of Science for papers published until June 2014. Additional publications were identified in the references cited in the initial papers. We used theoretical considerations to characterise approaches and noted empirical findings, when available. RESULTS: Of the 48 reviewed papers, only 24 reported empirical findings. The approaches to teaching CR were shown to vary on two dimensions. The first pertains to the way the case information is presented. The case is either unfolded to students gradually - the 'serial-cue' approach - or is presented in a 'whole-case' format. The second dimension concerns the purpose of the exercise: is its aim to help students acquire or apply knowledge, or is its purpose to teach students a way of thinking? The most prevalent approach is the serial-cue approach, perhaps because it tries to directly simulate the diagnostic activities of doctors. Evidence supporting its effectiveness is, however, lacking. There is some empirical evidence that whole-case, knowledge-oriented approaches contribute to the improvement of students' CR. However, thinking process-oriented approaches were shown to be largely ineffective. CONCLUSIONS: Based on research on how expertise develops in medicine, we argue that students in different phases of their training may benefit from different approaches to the teaching of CR. |
| File Format | HTM / HTML |
| ISSN | 03080110 |
| Issue Number | 10 |
| Journal | Medical Education |
| Volume Number | 49 |
| e-ISSN | 13652923 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2015-10-01 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Decision Making Clinical Medicine Education Narration Review Discipline Education Methods Standards Journal Article Teaching |
| Content Type | Text |
| Resource Type | Article |
| Subject | Education Medicine |
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