The Education and Implementation of Clinical Reasoning Education in Post-Graduate Emergency Medicine Training: An Integrative Review

Abstract

The ability to clinically reason is a necessity for doctors to reduce the possibility of diagnostic error in patients. Emergency medicine doctors work in a highly active, challenging and, at times, cognitively formidable setting that can affect clinical reasoning. This review aims to study the literature on post-graduate training programs and how clinical reasoning education is incorporated. Methods: CINAHL, Embase and Medline were used to obtain relevant literature from 2010 to 2023. A review was undertaken of clinical reasoning curriculums and resources in medical and surgical specialties in Australia, New Zealand, USA, UK, Ireland and Canada. Results: 23 articles were included in the review. Educational themes to teach clinical reasoning were a) simulation b) technological and innovative methods, c) morning report, d) peer teaching, and e) curriculum related. Surgery, General practice, and Internal Medicine colleges appear to have embedded clinical reasoning courses and resources within their curriculum and training. Conclusion: Specialty colleges are recognising the importance of clinical reasoning and have incorporated formal curricula into their training. Teaching can occur at a college, hospital and departmental level using a variety of educational modalities that vary in the resources required and is a possible option for Emergency Medicine training.