A comprehensive approach to identify challenges for clinical reasoning development in undergraduate dental students and their potential solutions

Abstract

IntroductionClinical reasoning is a core competence in health professions that impacts the ability to solve patients' health problems. Due to its relevance, it is necessary to identify difficulties arising from different sources that affect clinical reasoning development in students. The aim of this study was to explore a comprehensive approach to identify challenges for clinical reasoning development in undergraduate dental students and their potential solutions.MethodsMixed methods were used in four stages: (1) students and clinical teachers focus groups to identify challenges to clinical reasoning development; (2) literature review to explore potential solutions for these challenges; (3) Delphi technique for teacher consensus on pertinence and feasibility of solutions (1–5 scale); and (4) teachers' self‐perception of their ability to implement the solutions.ResultsThree categories and seven subcategories of challenges were identified: (I) educational context factors influencing the clinical reasoning process; (II) teacher's role in clinical reasoning development; and (III) student factors influencing the clinical reasoning process. From 134 publications identified, 53 were selected for review, resulting in 10 potential solutions. Through two Delphi rounds, teachers rated the potential solutions very highly in terms of relevance (4.50–4.85) and feasibility (3.50–4.29). Finally, a prioritisation ranking of these solutions was generated using their scores for relevance, feasibility, and teachers' self‐perception of their ability to implement them.ConclusionsThe present comprehensive approach identified challenges for clinical reasoning development in dental students and their potential solutions, perceived as relevant and feasible by teachers, requiring further research and follow‐up actions to address them.

Dental students’ perceptions of instructor storytelling for clinical learning: A qualitative description study

“…These findings contribute to the existing literature on clinical education as teaching clinical reasoning and meaningful knowledge application remain challenging across the health sciences. 12 Our findings are closely aligned with the principles of case-based learning, particularly the use of authentic cases to facilitate meaningful learning. 18 Previous research suggests that cases may improve clinical understanding and knowledge application if they are authentic, challenging, manageable, and relatable to the didactic content taught through lectures, and self-contained by providing the necessary information to be solved.…”

“…Our study suggests that these stories can potentially improve learning outcomes as long as they are based on authentic cases, emphasize clinical reasoning from different perspectives, and are educationally and clinically relevant. These findings contribute to the existing literature on clinical education as teaching clinical reasoning and meaningful knowledge application remain challenging across the health sciences 12 …”

“…Role modeling has rarely been employed for this purpose, even though research suggests it may positively influence attitudes, values, and competencies 26 . Combining the advantages of storytelling (e.g., increased attention and memorization) and those of modeling (e.g., skill development) may be promising to foster clinical reasoning and address the lack of teaching strategies to promote this competency in dental education 12 …”

“…Most stories in healthcare education are assumed to enhance learning by improving recall and promoting reflective dialogue. However, they can also facilitate vicarious learning of cognitive skills, including clinical reasoning, 11 which has proven to be challenging 12 . Although dental students have positively valued instructor stories, 13 little is known about student views of storytelling that model clinical care, including clinical reasoning.…”

“…However, they can also facilitate vicarious learning of cognitive skills, including clinical reasoning, 11 which has proven to be challenging. 12 Although dental students have positively valued instructor stories, 13 little is known about student views of storytelling that model clinical care, including clinical reasoning. Therefore, our study aimed to explore dental students' views of instructor storytelling with an emphasis on clinical reasoning.…”