ObjectivesClinical reasoning refers to the cognitive processes used by individuals as they formulate a diagnosis or treatment plan. Clinical reasoning is dependent on formal and experiential knowledge. Developing the ability to acquire and recall knowledge effectively for both analytical and non‐analytical cognitive processing has patient safety implications. This realist review examines the way educational interventions develop analytical and non‐analytical reasoning ability in undergraduate education. A realist review is theory‐driven, seeking not only to identify if an intervention works, but also understand the reasons why, for whom, and in what circumstances. The aim of this study is to develop understanding about the way educational interventions develop effective analytical and non‐analytical clinical reasoning ability, when they do, for whom and in what circumstances.MethodsLiterature from a scoping search, combined with expert opinion and researcher experience was synthesised to generate an initial programme theory (IPT). Four databases were searched and articles relevant to the developing theory were selected as appropriate. Factors affecting educational outcomes at the individual student, teacher and wider organisational levels were investigated in order to further refine the IPT.ResultsA total of 28 papers contributed to the overall programme theory. The review predominantly identified evidence of mechanisms for interventions at the individual student level. Key student level factors influencing the effectiveness of interventions included an individual's self‐confidence, self‐efficacy and pre‐existing level of knowledge. These contexts influenced a variety of educational interventions, impacting both positively and negatively on educational outcomes.ConclusionsDevelopment of analytical and non‐analytical clinical reasoning ability requires activities that enhance knowledge acquisition and recall alongside the accumulation of clinical experience and opportunities to practise reasoning in real or simulated clinical environments. However, factors such as pre‐existing knowledge and self‐confidence influence their effectiveness, especially amongst individuals with ‘low knowledge.’ Promoting non‐analytical reasoning once novices acquire more clinical knowledge is important for the development of clinical reasoning in undergraduate education.
Introduction: In 2003, the Institute of Medicine recommended that interprofessional education be incorporated into the training programs of health care professionals. However, many logistical challenges hinder formal interprofessional learning in health care profession programs. Methods: This resource is a 3-hour interprofessional small-group session designed for health professions student teams to engage in a standardized patient encounter, each team member contributing a profession-specific perspective to create a collaborative care plan across five discharge decisions. The activity includes a simulated standardized patient encounter and debrief session wherein students discuss the role of bias and communication and create a collaborative care plan. Results: Following the activity, participants were surveyed about the value of the educational experience. Over 12 months, 106 students (81 medicine, nine nursing, 16 pharmacy) participated in the interprofessional activity. Eighty-four students responded to the postevent survey (79% response rate). Students were confident that the experience helped them integrate profession-specific knowledge, create a shared care plan, and understand how interprofessional collaboration contributes to quality care. The debriefing session and interprofessional interaction were an integral component of the experience. Discussion: This resource is a feasible interprofessional smallgroup activity that has been implemented without excessive faculty time or institutional resources. It is adaptable to institutional needs, local resources, level of trainee, and professions. The session provides interprofessional students the opportunity to engage with one another and with the patient in a collaborative decision-making activity focused around a critical transition of care.
Background Entrustable professional activities (EPAs) are used in medical education in the assessment of clinical competence, but consideration of EPAs in nurse practitioner (NP) education is emerging. Problem There are critical points in the NP educational trajectory when a student should demonstrate requisite knowledge and abilities. It can be challenging to assess and measure clinical proficiency in a way that can be clearly interpreted by students, faculty, and preceptors. Approach NP faculty reviewed a set of medical EPAs that were linked with physician competencies to determine if they related to national NP competency areas and learning activities in their curriculum. Conclusions Several NP competency areas (8 of 9) related to these EPAs, and the learning activities also related to multiple EPAs. Although further work would be needed to tailor EPAs to the NP role and link them specifically with NP competencies, EPAs may offer another valuable method for clinical evaluation of NP students.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.