Now You See It, Now You Don't: What Thinking Aloud Tells Us About Clinical Reasoning

Bowen, Judith L.; Ilgen, Jonathan S.

doi:10.4300/jgme-d-14-00492.1

Cited by 9 publications

(6 citation statements)

References 20 publications

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“…Students believe that it is simpler to think when they are asked to verbalize their thoughts while searching for information to finish the major complaint. This method is known as the think-aloud technique and some of the benefits are outlined by Bowen and Ilgen [ 19 ] and Pinnock et al [ 20 ]. First, it explains and describes a complex and parallel information with clinical reasoning processes.…”

Section: Discussionmentioning

confidence: 99%

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Promoting medical student’s clinical reasoning during COVID-19 pandemic

Hermasari¹,

Nugroho²,

Maftuhah³

et al. 2023

Korean J Med Educ

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Purpose: The development of students’ clinical reasoning skills should be a consideration in the design of instruction and evaluation in medical education. In response to the coronavirus disease 2019 (COVID-19) pandemic, several changes in the medical curriculum have been implemented in promoting clinical reasoning. This study aims to explore medical students’ perceptions and experiences with the clinical reasoning curriculum during the COVID-19 pandemic and determine their skills development.Methods: The study used a mixed-method design with a concurrent approach. A cross-sectional study was conducted to compare and examine the relationship between the outcomes of the structured oral examination (SOE) and the Diagnostic Thinking Inventory (DTI). Then, the qualitative method was used. A focus group discussion using a semi-structured interview guide with open-ended questions was conducted, then the verbatim transcript was subjected to thematic analysis.Results: There is an increase in SOE and DTI scores between second-year to fourth-year students. The diagnostic thinking domains and SOE are significantly correlated (r=0.302, 0.313, and 0.241 with p<0.05). The three primary themes from the qualitative analysis are perceptions regarding clinical reasoning, clinical reasoning activities, and the learning component.Conclusion: Even if students are still studying throughout the COVID-19 pandemic, their clinical reasoning skills can improve. The clinical reasoning and diagnostic thinking skills of medical students increase as the length of the school year increases. Online case-based learning and assessment support the development of clinical reasoning skills. The skills are supported in their development by positive attitudes toward faculty, peers, case type, and prior knowledge.

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Section: Discussionmentioning

confidence: 99%

“…The introduction of coronavirus disease 2019 (COVID- 19) has presented medical education with unprecedented challenges. Early clinical attachment delivery, which is designed to prepare undergraduate students for the clinical environment and foster communication, history-taking, and examination skills [10], has faced difficulties.…”

Section: Introductionmentioning

confidence: 99%

Promoting medical student’s clinical reasoning during COVID-19 pandemic

Hermasari¹,

Nugroho²,

Maftuhah³

et al. 2023

Korean J Med Educ

View full text Add to dashboard Cite

show abstract

“…According to Bowen and Ilgen, diagnostic reasoning is not a discrete, enduring, or reliably measurable skill. Accurate measurement in fact requires an observer to interpret processes that are heavily context dependent, usually not explicitly articulated, and often occur below conscious awareness of the observed clinician (Bowen and Ilgen 2014). Nevertheless, authors have attempted to infer progress in clinical reasoning ability across years using a written progress test (Williams et al 2011 Case-based clinical reasoning education, or any other approach recommended for preclinical education, attempts to prepare students for clinical encounters.…”

Section: How Does the Cbcr Methods Address These Prerequisites?mentioning

confidence: 99%

Principles and Practice of Case-based Clinical Reasoning Education

Cate

Custers

Durning

2018

Innovation and Change in Professional Education

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“…The cognitive process of clinical reasoning varied involves the following: hypothetico-deductive [38], elaborated hypothetico-deductive [39], heuristic reasoning [40], schema-induction reasoning [41,42], and pattern recognition [33,43]. The reasoning process can be determined by analyzing the content of transcription result from think aloud methods and contrasting and comparing with known clinical reasoning pattern [44][45][46].…”

Section: Process Paradigm Of Clinical Reasoningmentioning

confidence: 99%

Clinical reasoning pattern used in oral health problem solving – A case study in Indonesian undergraduate dental students

et al. 2023

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Background Health professionals are known to use various combinations of knowledge and skills, such as critical thinking, clinical reasoning, clinical judgment, problem-solving, and decision-making, in conducting clinical practice. Clinical reasoning development is influenced by knowledge and experience, the more knowledge and experience, the more sophisticated clinical reasoning will be. However, clinical reasoning research in dentistry shows varying results . Aims This study aims to observe the clinical reasoning pattern of undergraduate dental students when solving oral health problems, and their accordance with their knowledge acquisition. Material and methods This qualitative study employed the think-aloud method and the result was assessed through verbal protocol analyses. Five respondents from final year dental undergraduate students were agreed to participate. A unique hypothetical clinical scenario was used as a trigger. The audio data were transcribed, interpreted, and categorized as a clinical reasoning pattern; and the concept maps created were assessed by a Structure of Learning Outcomes (SOLO) taxonomy as knowledge acquisition. Results Observations on clinical reasoning patterns and the level of knowledge acquisition in five undergraduate dental students showed varying results. They applied clinical reasoning patterns according to their knowledge acquisition during didactical phase. Learners with inadequate knowledge relied on guessing, meanwhile learners with adequate knowledge applied more sophisticated reasoning pattern when solving problems. Conclusions Various problem-solving strategies were encountered in this study, which corresponded to the level of knowledge acquisition. Dental institutions must set minimum standards regarding the acquisition of conceptual knowledge accompanied by improvement of clinical reasoning skills, as well as refinement of knowledge and procedural skills.

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Now You See It, Now You Don't: What Thinking Aloud Tells Us About Clinical Reasoning

Cited by 9 publications

References 20 publications

Promoting medical student’s clinical reasoning during COVID-19 pandemic

Promoting medical student’s clinical reasoning during COVID-19 pandemic

Principles and Practice of Case-based Clinical Reasoning Education

Clinical reasoning pattern used in oral health problem solving – A case study in Indonesian undergraduate dental students

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