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Bringing explicit insight into cognitive psychology features during clinical reasoning seminars: a prospective, controlled study.
Educ Health (Abingdon). 2011 Apr; 24(1):496.EH

Abstract

CONTEXT

Facets of reasoning competence influenced by an explicit insight into cognitive psychology features during clinical reasoning seminars have not been specifically explored.

OBJECTIVE

This prospective, controlled study, conducted at the University of Geneva Faculty of Medicine, Switzerland, assessed the impact on sixth-year medical students' patient work-up of case-based reasoning seminars, bringing them explicit insight into cognitive aspects of their reasoning.

METHODS

Volunteer students registered for our three-month Internal Medicine elective were assigned to one of two training conditions: standard (control) or modified (intervention) case-based reasoning seminars. These seminars start with the patient's presenting complaint and the students must ask the tutor for additional clinical information to progress through case resolution. For this intervention, the tutors made each step explicit to students and encouraged self-reflection on their reasoning processes. At the end of their elective, students' performances were assessed through encounters with two standardized patients and chart write-ups.

FINDINGS

Twenty-nine students participated, providing a total of 58 encounters. The overall differences in accuracy of the final diagnosis given to the patient at the end of the encounter (control 63% vs intervention 74%, p = 0.53) and of the final diagnosis mentioned in the patient chart (61% vs 70%, p = 0.58) were not statistically significant. The students in the intervention group significantly more often listed the correct diagnosis among the differential diagnoses in their charts (75% vs 97%, p = 0.02).

CONCLUSION

This case-based clinical reasoning seminar intervention, designed to bring students insight into cognitive features of their reasoning, improved aspects of diagnostic competence.

Authors+Show Affiliations

Nendaz MR
University ofGeneva Faculty of Medicine, Geneva. mathieu.nendaz@hcuge.ch
Gut AM
No affiliation info available
Louis-Simonet M
No affiliation info available
Perrier A
No affiliation info available
Vu NV
No affiliation info available

MeSH

Clinical CompetenceDecision MakingDiagnosis, DifferentialEducation, Medical, UndergraduateFemaleHumansMaleProspective StudiesStudents, MedicalSwitzerlandThinking

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21710417

Citation

Nendaz, Mathieu R., et al. "Bringing Explicit Insight Into Cognitive Psychology Features During Clinical Reasoning Seminars: a Prospective, Controlled Study." Education for Health (Abingdon, England), vol. 24, no. 1, 2011, p. 496.
Nendaz MR, Gut AM, Louis-Simonet M, et al. Bringing explicit insight into cognitive psychology features during clinical reasoning seminars: a prospective, controlled study. Educ Health (Abingdon). 2011;24(1):496.
Nendaz, M. R., Gut, A. M., Louis-Simonet, M., Perrier, A., & Vu, N. V. (2011). Bringing explicit insight into cognitive psychology features during clinical reasoning seminars: a prospective, controlled study. Education for Health (Abingdon, England), 24(1), 496.
Nendaz MR, et al. Bringing Explicit Insight Into Cognitive Psychology Features During Clinical Reasoning Seminars: a Prospective, Controlled Study. Educ Health (Abingdon). 2011;24(1):496. PubMed PMID: 21710417.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bringing explicit insight into cognitive psychology features during clinical reasoning seminars: a prospective, controlled study. AU - Nendaz,Mathieu R, AU - Gut,Anne M, AU - Louis-Simonet,Martine, AU - Perrier,Arnaud, AU - Vu,Nu V, Y1 - 2011/04/09/ PY - 2011/6/29/entrez PY - 2011/6/29/pubmed PY - 2011/11/1/medline SP - 496 EP - 496 JF - Education for health (Abingdon, England) JO - Educ Health (Abingdon) VL - 24 IS - 1 N2 - CONTEXT: Facets of reasoning competence influenced by an explicit insight into cognitive psychology features during clinical reasoning seminars have not been specifically explored. OBJECTIVE: This prospective, controlled study, conducted at the University of Geneva Faculty of Medicine, Switzerland, assessed the impact on sixth-year medical students' patient work-up of case-based reasoning seminars, bringing them explicit insight into cognitive aspects of their reasoning. METHODS: Volunteer students registered for our three-month Internal Medicine elective were assigned to one of two training conditions: standard (control) or modified (intervention) case-based reasoning seminars. These seminars start with the patient's presenting complaint and the students must ask the tutor for additional clinical information to progress through case resolution. For this intervention, the tutors made each step explicit to students and encouraged self-reflection on their reasoning processes. At the end of their elective, students' performances were assessed through encounters with two standardized patients and chart write-ups. FINDINGS: Twenty-nine students participated, providing a total of 58 encounters. The overall differences in accuracy of the final diagnosis given to the patient at the end of the encounter (control 63% vs intervention 74%, p = 0.53) and of the final diagnosis mentioned in the patient chart (61% vs 70%, p = 0.58) were not statistically significant. The students in the intervention group significantly more often listed the correct diagnosis among the differential diagnoses in their charts (75% vs 97%, p = 0.02). CONCLUSION: This case-based clinical reasoning seminar intervention, designed to bring students insight into cognitive features of their reasoning, improved aspects of diagnostic competence. SN - 1469-5804 UR - https://www.unboundmedicine.com/medline/citation/21710417/Bringing_explicit_insight_into_cognitive_psychology_features_during_clinical_reasoning_seminars:_a_prospective_controlled_study_ DB - PRIME DP - Unbound Medicine ER -