BACKGROUND AND OBJECTIVES: Most medical students learn clinical reasoning skills informally during clinical rotations that have varying quality of supervision. We conducted a randomized controlled trial to determine if a workshop that uses "illness scripts" could improve students' clinical reasoning skills when making diagnoses of patients portrayed in written scenarios. METHODS:In 2007--2008, 53 fourth-year medical students were randomly assigned to either a family medicine (intervention) or psychiatry (control) clerkship at The Chinese University of Hong Kong. Students in the intervention group participated in a 3-hour workshop on clinical reasoning that used illness scripts. The workshop was conducted with small-group teaching using a Web-based set of clinical reasoning problems, individualized feedback, and demonstration of tutors' reasoning aloud. The effectiveness of the intervention was assessed using the Diagnostic Thinking Inventory (DTI) and the measurement of individual students' performance in solving clinical reasoning problems (CRP). RESULTS: The post-intervention overall DTI scores between groups were similar (mean difference 0, 95% confidence interval [CI]= -7.4 to 7.4). However, the total scores on the CRP assessment were 14% (95% CI=8% to 21%) higher in the intervention group than in controls. CONCLUSION: A workshop on illness scripts may have some benefit for improving diagnostic performance in clinical reasoning problems.
RCT Entities:
BACKGROUND AND OBJECTIVES: Most medical students learn clinical reasoning skills informally during clinical rotations that have varying quality of supervision. We conducted a randomized controlled trial to determine if a workshop that uses "illness scripts" could improve students' clinical reasoning skills when making diagnoses of patients portrayed in written scenarios. METHODS: In 2007--2008, 53 fourth-year medical students were randomly assigned to either a family medicine (intervention) or psychiatry (control) clerkship at The Chinese University of Hong Kong. Students in the intervention group participated in a 3-hour workshop on clinical reasoning that used illness scripts. The workshop was conducted with small-group teaching using a Web-based set of clinical reasoning problems, individualized feedback, and demonstration of tutors' reasoning aloud. The effectiveness of the intervention was assessed using the Diagnostic Thinking Inventory (DTI) and the measurement of individual students' performance in solving clinical reasoning problems (CRP). RESULTS: The post-intervention overall DTI scores between groups were similar (mean difference 0, 95% confidence interval [CI]= -7.4 to 7.4). However, the total scores on the CRP assessment were 14% (95% CI=8% to 21%) higher in the intervention group than in controls. CONCLUSION: A workshop on illness scripts may have some benefit for improving diagnostic performance in clinical reasoning problems.
Authors: Jettie Vreugdenhil; Donna Döpp; Eugène J F M Custers; Marcel E Reinders; Jos Dobber; Rashmi A Kusukar Journal: J Adv Nurs Date: 2021-08-11 Impact factor: 3.057
Authors: Pradeep Paul George; Nikos Papachristou; José Marcano Belisario; Wei Wang; Petra A Wark; Ziva Cotic; Kristine Rasmussen; René Sluiter; Eva Riboli-Sasco; Lorainne Tudor Car; Eve Marie Musulanov; Joseph Antonio Molina; Bee Hoon Heng; Yanfeng Zhang; Erica Lynette Wheeler; Najeeb Al Shorbaji; Azeem Majeed; Josip Car Journal: J Glob Health Date: 2014-06 Impact factor: 4.413