A Preclinical Course to Develop Clinical Reasoning Skills of First-year Medical Students

Abstract

Background and Objectives: Clinical reasoning is developed sometime during medical school training. When and how this knowledge is attained is less clear. This study looks at clinical reasoning development after initiation of a rural experiential course for first-year medical students at the University of Minnesota Medical School, Duluth (regional) Campus. Methods: The Rural Medical Scholars Program course (RMSP) was developed to create a longitudinal rural family medicine experience for first and second-year students at the University of Minnesota Medical School Duluth. Sixtythree first year medical students participated in this required course and their clinical reasoning levels were measured using the Diagnostic Thinking Inventory (DTI). The DTI was given to the medical students after one year of participation in the RMSP course. A previous cohort before the RMSP course was developed was used as a control. A literature search was used for comparison to other schools that measured the DTI in their students. Results: Student diagnostic thinking performance as measured by the DTI after one year of the Rural Medical Scholars Program course significantly increased when compared to a previous cohort of first-year students who did not take the RMSP course. When compared to previously published DTI data, students after one year of RMSP had clinical reasoning levels of second through fourth-year students from other schools. Conclusions: The addition of a rural experiential course with family medicine preceptors significantly increased clinical reasoning levels of first-year medical students.

Analysis of Patient Information and Differential Diagnosis with Clinical Reasoning in Pre-Clinical Medical Students

“…Education in CR is crucial in the early preclinical stage, as it lays the foundation for medical students' clinical competence, particularly in decision making for later clinical training [14]. It is important that student preparation for clinical encounters be improved to minimize diagnostic errors and negative consequences [15][16][17]. The pedagogy consisted of small group work guided by preceptors, large group lectures, case-based learning, and asynchronous individual work [14].…”

Evaluation of development of clinical reasoning skills in dental students through diagnostic thinking inventory

“…[6][7][8][9] The emphasis on how to teach clinical reasoning started in medical education and to assess the results, diagnostic thinking inventory (DTI) was used for rating Standardized patients (SP). 10,12 In dentistry, a few studies exist on clinical reasoning skills demonstrating them through clinical scenarios, but none shows a definite pattern/ definite tool to assess. 13,14 In medical sciences, the learning and developing of clinical reasoning skills is a topic on which a lot of work has been done.…”