Abstract
Clinical reasoning ability is an important competence for a clinician to have. Undergraduate study is a crucial period to strengthen medical students' clinical reasoning skills. The aim of this study was to explore an effective method for guiding students to improve clinical reasoning skills via a step-by-step presentation of case information. The study was conducted among grade 2015 clinical medicine major students who were studying internal medicine. On the basis of the theoretical study and practical training, a method for the step-by-step presentation of case information was designed and implemented to strengthen students’ clinical reasoning skills. Each case was divided into four modules. Module one focused on inquiry, module two focused on physical examination, module three focused on laboratory tests and module four focused on diagnosis and treatment. Four modules were sent to students in turn as homework. The teacher corrected their answers and feedback was individually given. A questionnaire was conducted at the end of semester to assess the effect. The questionnaire revealed that students were satisfied with this training mode. They thought the mode was helpful for improving clinical reasoning ability and consolidating the basic skills such as history taking and physical examination. In conclusion, this effective method provides a training pattern for developing clinical reasoning skills of medical students. Through the process of analysing clinical cases, students are guided to become familiar with the procedures of solving clinical problems from gathering medical information to establishing diagnosis and treatment plans. It helps students to establish a scientific clinical reasoning mode.
Highlights
Diagnosis-making is a basic practice for any doctor
The mode of the step-by-step presentation of case information was helpful for improving clinical reasoning ability
The mode of the step-by-step presentation of case information was helpful for consolidating history taking and physical examination skills
Summary
Diagnosis-making is a basic practice for any doctor. It is a process in which doctors draw conclusions by making analyses, summaries, judgement and reasoning based on the information acquired through inquiry, physical examination and auxiliary examination. In the process of making correct diagnosis and treatment, an important ability is applied, that is clinical reasoning. Clinical reasoning is considered to be the cornerstone and main component of a doctor's clinical abilities (Audétat et al, 2012). It refers to the process by which doctors gather medical information and make diagnosis and treatment plans (Daly, 2018; Dong et al, 2015; Elvén, Hochwälder, Dean & Söderlund 2019; Shin, 2019). Clinical reasoning includes diagnostic reasoning and therapeutic reasoning (McBee et al, 2015) This process includes the application and integration of theoretical knowledge, clinical experience, critical thinking skills and reflection. We usually say that “a correct diagnosis and treatment relies on a correct clinical reasoning”
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