Use of Case-Based Clinical Reasoning in Medical Education at Libyan International University: A quantitative Study.

Abstract

Background: Clinical instruction in medical education is a complex and challenging task for educators. It requires students to not only possess theoretical knowledge but also a range of competencies such as clinical reasoning, technical skills, decision-making, ethics, leadership, and time management. Clinical reasoning, which encompasses the cognitive process and decision-making in clinical practice, is a fundamental skill for physicians. The aim of the study was to understand students' views on the use of case-based clinical reasoning (CBCR) in their medical training and evaluate their satisfaction with its application as an instructional approach for developing clinical reasoning abilities. Participants and Methods: A descriptive quantitative study was conducted at the Libyan International Medical University (LIMU) to gather data on the utilization of case-based clinical reasoning (CBCR) in medical training. The study focused on 412 medical students in the clinical phase, including 4th and 5th-year students and intern doctors at LIMU. Data were collected through an online questionnaire over a two-month period from January to March 2023. The analysis was based on 129 responses, representing a 30.1% response rate. The questionnaire consisted of 22 questions, including multiple-choice and Likert scale inquiries, and aimed to assess students' satisfaction in three dimensions: perceived benefits and drawbacks of CBCR in medical education, skill enhancement and its impact on self-assurance and teamwork, and the role of LIMU in successfully implementing the program. Data analysis was performed using the SPSS software, with a statistical significance level set at p < 0.05. Results: The study found that students perceive several benefits of using case-based clinical reasoning (CBCR) in their medical training. These benefits include the accumulation of knowledge and the improvement of skills such as teamwork, communication, critical thinking, reasoning, and self-directed learning abilities. A significant majority of students, approximately three-quarters of the sample, endorsed the use of CBCR with their peers and colleagues. Almost all respondents agreed that CBCR helps them make informed decisions in their daily practice and boosts their confidence in advancing their medical careers (93% and 86.8% agreement, respectively). Higher satisfaction levels were reported among fifth-year students and during the internship phase. However, fourth-year students expressed more dissatisfaction with CBCR, finding it time-consuming and facing challenges in formulating hypotheses for data collection. In conclusion, the study highlights the importance of adopting a proactive approach in medical education to promote educational innovation. Employing case-based clinical reasoning (CBCR) is found to be effective in developing clinical competencies, fostering collaboration, enhancing self-assurance, and cultivating critical thinking abilities among students.