Clinical reasoning difficulties: A taxonomy for clinical teachers

Background: Clinical reasoning is the cornerstone of medical practice. To date, there is no established framework regarding clinical reasoning difficulties, how to identify them, and how to remediate them. Aim: To identify the most common clinical reasoning difficulties as they present in residents&...

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Bibliographic Details
Published in:Medical teacher 2013-01, Vol.35 (3), p.e984-e989
Main Authors: Audétat, Marie-Claude, Laurin, Suzanne, Sanche, Gilbert, Béïque, Caroline, Fon, Nathalie Caire, Blais, Jean-Guy, Charlin, Bernard
Format: Article
Language:English
Subjects:
Classification
Clinical education
Clinical reasoning
Cognition & reasoning
Decision Making
Decision Support Techniques
Diagnosis
Educational Diagnosis
Faculty, Medical
Family Practice
Health Services Research
Humans
Learning
Participatory action research
Problem-Based Learning
Research Methodology
Students, Medical - psychology
Teachers
Teaching methods
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Summary:Background: Clinical reasoning is the cornerstone of medical practice. To date, there is no established framework regarding clinical reasoning difficulties, how to identify them, and how to remediate them. Aim: To identify the most common clinical reasoning difficulties as they present in residents' patient encounters, case summaries, or medical notes. To develop a guide to support medical educators' process of educational diagnosis and management in this area. Methods: We used a participatory action research method. We carried out eight iterative reflective cycles with a group of clinical teachers. The repeated phases of experimentation and observation were conducted by participants in their own clinical teaching setting. Our findings were tested and validated on both an individual and collective basis Results: We found five categories of clinical reasoning difficulties as they present in the clinical teaching settings. We identified indicators for each. Indicators may be different depending on the type of supervision. These findings were assembled and organized to construct a guide for clinical teachers. Conclusions: The guide should assist clinical teachers in detecting clinical reasoning difficulties during clinical teaching and in providing remediation that is tailored to the specific difficulty identified. Its development furthers our understanding of clinical reasoning difficulties and provides a useful tool.
ISSN:0142-159X
1466-187X
DOI:10.3109/0142159X.2012.733041