Clinical reasoning model for pharmacy students.

BACKGROUND: Clinical reasoning is an essential health care professional skill. Typically, pharmacy students figure out how to reason clinically on their own through the observation of skilled clinicians in various patient care settings. The need to start developing clinical reasoning skills in the pre-clinical years has increased interest in classroom-based clinical reasoning instruction. CONTEXT: The focus of the current clinical reasoning literature is on teaching and assessing medical student clinical reasoning skills. Some literature is available for other health care professions, but there is little information regarding pharmacy student clinical reasoning skills. The current accreditation standards for pharmacy education in the USA require the assessment of clinical reasoning skills, but do not provide guidance regarding content, depth or breadth of skill development. INNOVATION: A 2-credit pharmacy elective clinical reasoning course and a new integrated clinical reasoning model were developed for first-, second- and third-year pre-clinical Doctor of Pharmacy students. The new integrated clinical reasoning model, designed to guide pharmacy students through the clinical reasoning processes for making patient-specific therapeutic recommendations, integrates standard Subjective-Objective-Assessment-Planning (SOAPing) processes with pharmacy-specific elements of clinical reasoning. IMPLICATIONS: Student achievement on whole case-based exams, designed to assess clinical reasoning skills, and student satisfaction with the course were high; however, longitudinal experience with cohorts internal and external to this institution is necessary to determine whether this type of course and clinical reasoning model is scalable, and whether the model has a measurable impact on student performance in the clinical year of the curriculum.