Abstract
BackgroundClinical reasoning is fundamental to all forms of professional health practice, however it is also difficult to teach and learn because it is complex, tacit, and effectively invisible for students. In this paper we present an approach for teaching clinical reasoning based on making expert thinking visible and accessible to students.MethodsTwenty-one experienced allied health clinical educators from three tertiary Australian hospitals attended up to seven action research discussion sessions, where they developed a tentative heuristic of their own clinical reasoning, trialled it with students, evaluated if it helped their students to reason clinically, and then refined it so the heuristic was targeted to developing each student’s reasoning skills. Data included participants’ written descriptions of the thinking routines they developed and trialed with their students and the transcribed action research discussion sessions. Content analysis was used to summarise this data and categorise themes about teaching and learning clinical reasoning.ResultsTwo overriding themes emerged from participants’ reports about using the ‘making thinking visible approach’. The first was a specific focus by participating educators on students’ understanding of the reasoning process and the second was heightened awareness of personal teaching styles and approaches to teaching clinical reasoning.ConclusionsWe suggest that the making thinking visible approach has potential to assist educators to become more reflective about their clinical reasoning teaching and acts as a scaffold to assist them to articulate their own expert reasoning and for students to access and use.
Highlights
Clinical reasoning is fundamental to all forms of professional health practice, it is difficult to teach and learn because it is complex, tacit, and effectively invisible for students
Clinical reasoning is fundamental to all forms of healthcare practice [1], but it is difficult to teach because it is complex, situation specific, built up through experience and frequently based on tacit, automatic processes of pattern recognition [2,3,4,5,6]
In this article we introduce and evaluate, an approach to teaching clinical reasoning based on the pedagogical method of making thinking visible [16,17]
Summary
Clinical reasoning is fundamental to all forms of professional health practice, it is difficult to teach and learn because it is complex, tacit, and effectively invisible for students. Clinical reasoning is fundamental to all forms of healthcare practice [1], but it is difficult to teach because it is complex, situation specific, built up through experience and frequently based on tacit, automatic processes of pattern recognition [2,3,4,5,6]. It involves gathering and analyzing information (diagnostic reasoning) as well as deciding on therapeutic actions specific to a patient’s. The goal, when applied to teaching clinical reasoning is to assist educators to use a type of metacognition (thinking about their own thinking) [18] to reveal the otherwise ‘hidden’ elements of their reasoning [19], as an explicit scaffold to guide their students’ thinking and reasoning
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