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Title: Teaching clinical reasoning skills to undergraduate medical students : an action research study
Author: Lockwood, P.
ISNI:       0000 0004 7428 4798
Awarding Body: University of Liverpool
Current Institution: University of Liverpool
Date of Award: 2017
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Introduction Clinical Reasoning is an important competency for medical students to learn. I am a Clinical Lecturer in Medicine and I run a course which has clinical reasoning as a key component. It was identified at curriculum meetings, that Clinical reasoning can be challenging to teach and that there was some evidence that it is an area of the curriculum that could be further developed and improved upon. Study Aim To address the concern about improving the teaching of clinical reasoning skills, my study aimed to; • Develop effective approaches for teaching clinical reasoning to medical students and evaluate them, • Identify educational principles that would help students learn clinical reasoning and share them with curriculum developers, The questions that I identified to support this aim were; • What enhances the students’ ability to learn clinical reasoning? • What makes it harder to learn clinical reasoning? New knowledge was developed by exploring how the theories around clinical reasoning and its teaching could be applied in a practical setting. Methodology An action research approach was used to identify the concerns and issues around teaching clinical reasoning, look for solutions, plan and implement changes and evaluate the changes. The last element of the study was the development of principles when developing a curriculum or teaching sessions for clinical reasoning. Results A new teaching session was designed and delivered to third year medical students. Several key factors important in designing a teaching session around clinical reasoning were identified. Scenarios used in clinical reasoning teaching should be written so that the information in the history is nonspecific and broad enough to allow for thinking across different body systems. They also should be well written to allow actors to play the simulated patient role realistically. The tutors involved need to have the skills to encourage the students to apply knowledge to the scenario through interaction. The tutors need to be able to engender a feeling of safety within the group being taught. There are some indications that the tutors need to have a high level of metacognition themselves. Students need to practice using the clinical reasoning processes and receive feedback on their thought processes. The teaching sessions need to allow time for the students to think and a stop start method was highly rated by the students as a method for doing this. Assessments and teaching materials around clinical reasoning need to avoid the use of “buzz words” or formulaic thinking. Further research into how novices use the clinical reasoning process is needed, as the study suggested that students use inductive reasoning and leave it late to start the reasoning process. They also try and use pattern recognition using “buzz words” very early on in their career.
Supervisor: Strivens, Janet ; Gray, Morag Sponsor: Not available
Qualification Name: Thesis (Ed.D.) Qualification Level: Doctoral