Perspectives on the current state of pre-clerkship clinical reasoning instruction in United States medical schools: a survey of clinical skills course directors
| Autor: | Robin K. Ovitsh, Joel Appel, Danielle Roussel, Sandra K. Oza, Roshini Pinto-Powell, Shanu Gupta, Jennifer M Jackson, Candace J. Chow |
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| Rok vydání: | 2021 |
| Předmět: |
020205 medical informatics
media_common.quotation_subject Clinical Biochemistry Medicine (miscellaneous) 02 engineering and technology Clinical Reasoning 03 medical and health sciences 0302 clinical medicine State (polity) Surveys and Questionnaires 0202 electrical engineering electronic engineering information engineering Humans Narrative 030212 general & internal medicine Curriculum Schools Medical media_common Medical education Health Policy Biochemistry (medical) Public Health Environmental and Occupational Health Clinical reasoning Clinical Clerkship United States Formal instruction Needs assessment Clinical Competence Psychology Inclusion (education) Clinical skills |
| Zdroj: | Diagnosis (Berlin, Germany)References. 9(1) |
| ISSN: | 2194-802X |
| Popis: | Objectives Clinical reasoning skills are essential for sound medical decision-making. Though many have suggested that clinical reasoning instruction should begin in pre-clerkship curricula, neither pre-clerkship clinical skills director perspectives nor extent of instruction is known. This survey study serves as part of a needs assessment for United States medical school pre-clerkship clinical reasoning curricula. Methods United States medical school pre-clerkship clinical skills course directors were surveyed about perceived importance of formal instruction on clinical reasoning concepts, inclusion of these concepts in the curricula, barriers to instruction, and familiarity with clerkship curricula. Results were analyzed using descriptive and analytic statistics. Narrative comments were analyzed qualitatively for themes. Results Of 148 directors surveyed, 102 (69%) participated and 89 (60%) completed all closed-ended items. Each clinical reasoning concept was identified as somewhat to extremely important to include in pre-clerkship curricula by 90–99% of respondents. Pre-clerkship curricula included variable degrees of formal instruction for concepts, though most respondents rated their inclusion as moderate or extensive. Perceived importance of teaching most concepts moderately correlated with the degree of inclusion in the curriculum (Spearman’s rho 0.39–0.44). Curricular time constraints and lack of faculty with skills to teach these concepts were the most frequently cited barriers to instruction. Respondents indicated being somewhat 57% (n=54) to extremely 29% (n=27) familiar with clerkship curricula at their institutions. Conclusions This study is the first to examine pre-clerkship clinical skills course director perspectives about clinical reasoning instruction and extent of its inclusion in their curricula. |
| Databáze: | OpenAIRE |
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