A Team-based Learning Approach During Pediatric Clerkship to Promote Clinical Reasoning.

BACKGROUND: Clinical reasoning skills are essential to medical practice. The problem lies in assuming junior medical students with limited experience develop clinical reasoning and decision-making skills passively and solely through clinical exposure. To prepare learners for independent practice and...

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Publicado en:Academic Pediatrics Vol. 23; no. 7; pp. 1459 - 1465
Autores principales: Forbes, Karen L., Foulds, Jessica L.
Formato: research tables/charts Journal Article
Publicado: Elsevier B.V. Sep/Oct2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep/Oct2023
      vid: 23
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      pub: Elsevier B.V.
      place: New York, New York
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        10.1016/j.acap.2023.04.002
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        atl: A Team-based Learning Approach During Pediatric Clerkship to Promote Clinical Reasoning.
      aug:
        au:
          Forbes, Karen L.
          Foulds, Jessica L.
        affil: Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
      sug:
        subj:
          Teamwork
          Clinical Reasoning
          Students, Medical
          Problem-Based Learning Methods
          Student Experiences
          Learning Environment
          Decision Making, Clinical
          Academic Performance
          Human
          Male
          Female
          Curriculum Development
          Course Evaluation
          Descriptive Statistics
          Psychometrics
          Comparative Studies
          Correlational Studies
          Male
          Female
      ab: BACKGROUND: Clinical reasoning skills are essential to medical practice. The problem lies in assuming junior medical students with limited experience develop clinical reasoning and decision-making skills passively and solely through clinical exposure. To prepare learners for independent practice and care for future patients, explicit teaching and assessment of clinical reasoning in low-stakes, collaborative learning environments are needed. METHODS: The key-feature question (KFQs) format is an assessment approach that focuses on the reasoning and decision- making aspects of medical problems rather than knowledge recall. This report describes the development, implementation, and evaluation of a team-based learning (TBL) approach using KFQs to foster clinical reasoning in the third-year pediatric clerkship at our institution. RESULTS: Over the first 2 years of implementation (2017--18, 2018--19), 278 students participated in TBL sessions. Mean individual student scores significantly improved in the group setting for both academic years (P < .001). Individual scores were moderately positively correlated with their total summative Objective Structured Clinical Examination score (r [275] = 0.51; P < .001). The correlation between individual score and their multiple-choice question examination was weaker at 0.29 (P < .001) but remained positive. CONCLUSIONS: A TBL session using KFQs to both teach and assess clinical reasoning in clerkship students may help educators identify students with gaps in knowledge and/or reasoning. The next steps include developing and implementing individualized coaching opportunities, and expanding this approach within the undergraduate medical curriculum. Outcome measures to assess clinical reasoning in authentic patient encounters require further research and development.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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