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Monitoring progression of clinical reasoning skills during health sciences education using the case method - A qualitative observational study

Orban, Kristina LU ; Ekelin, Maria LU ; Edgren, Gudrun LU ; Sandgren, Olof LU ; Hovbrandt, Pia LU and Persson, Eva K. LU (2017) In BMC Medical Education 17(1).
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. 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... (More)

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. 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. 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. 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.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Clinical problem-solving, Health sciences education, Professional development, Qualitative content analysis
in
BMC Medical Education
volume
17
issue
1
publisher
BioMed Central
external identifiers
  • scopus:85029296021
  • wos:000410246100002
ISSN
1472-6920
DOI
10.1186/s12909-017-1002-4
language
English
LU publication?
yes
id
93977f0a-9916-499c-a07f-60a269e8a548
date added to LUP
2017-10-03 08:53:45
date last changed
2018-01-16 13:20:23
@article{93977f0a-9916-499c-a07f-60a269e8a548,
  abstract     = {<p>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. 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. 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. 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.</p>},
  articleno    = {158},
  author       = {Orban, Kristina and Ekelin, Maria and Edgren, Gudrun and Sandgren, Olof and Hovbrandt, Pia and Persson, Eva K.},
  issn         = {1472-6920},
  keyword      = {Clinical problem-solving,Health sciences education,Professional development,Qualitative content analysis},
  language     = {eng},
  month        = {09},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {BMC Medical Education},
  title        = {Monitoring progression of clinical reasoning skills during health sciences education using the case method - A qualitative observational study},
  url          = {http://dx.doi.org/10.1186/s12909-017-1002-4},
  volume       = {17},
  year         = {2017},
}