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Monitoring progression of clinical reasoning skills during health sciences education using the case method - a qualitative observational study.
- Source :
-
BMC medical education [BMC Med Educ] 2017 Sep 11; Vol. 17 (1), pp. 158. Date of Electronic Publication: 2017 Sep 11. - Publication Year :
- 2017
-
Abstract
- Background: Outcome- or competency-based education is well established in medical and health sciences education. Curricula are based on courses where students develop their competences and assessment is also usually course-based. Clinical reasoning is an important competence, and the aim of this study was to monitor and describe students' progression in professional clinical reasoning skills during health sciences education using observations of group discussions following the case method.<br />Methods: In this qualitative study students from three different health education programmes were observed while discussing clinical cases in a modified Harvard case method session. A rubric with four dimensions - problem-solving process, disciplinary knowledge, character of discussion and communication - was used as an observational tool to identify clinical reasoning. A deductive content analysis was performed.<br />Results: The results revealed the students' transition over time from reasoning based strictly on theoretical knowledge to reasoning ability characterized by clinical considerations and experiences. Students who were approaching the end of their education immediately identified the most important problem and then focused on this in their discussion. Practice knowledge increased over time, which was seen as progression in the use of professional language, concepts, terms and the use of prior clinical experience. The character of the discussion evolved from theoretical considerations early in the education to clinical reasoning in later years. Communication within the groups was supportive and conducted with a professional tone.<br />Conclusions: Our observations revealed progression in several aspects of students' clinical reasoning skills on a group level in their discussions of clinical cases. We suggest that the case method can be a useful tool in assessing quality in health sciences education.
- Subjects :
- Academic Medical Centers
Boston
Curriculum
Educational Measurement
Female
Humans
Male
Qualitative Research
Young Adult
Clinical Competence standards
Competency-Based Education
Education, Medical, Graduate
Education, Medical, Undergraduate
Problem Solving
Simulation Training standards
Students, Medical
Subjects
Details
- Language :
- English
- ISSN :
- 1472-6920
- Volume :
- 17
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC medical education
- Publication Type :
- Academic Journal
- Accession number :
- 28893238
- Full Text :
- https://doi.org/10.1186/s12909-017-1002-4