A Tool to Share Clinical Reasoning Asynchronously (Preprint)

Abstract

BACKGROUND Trainees rely on clinical experience to learn clinical reasoning in pediatric emergency medicine (PEM). Outside of clinical experience, graduate medical education provides a handful of explicit activities focused on developing skills in clinical reasoning. OBJECTIVE Describe the development, use, and changing perceptions of an online asynchronous tool to facilitate clinical reasoning discussion for PEM providers. METHODS We created a case-based online discussion tool for PEM clinicians and fellows to post and discuss cases. We examined website analytics for site use and collected user survey data over a 3-year period to assess utilization and acceptability of the tool. RESULTS The learning tool had more than 30,000 site visits and 172 case comments for the 55 published cases over three years. Self-reported engagement with the learning tool varied inversely with clinical experience in PEM. The tool was relevant to clinical practice and useful for learning pediatric emergency medicine for most respondents. The most experienced clinicians were more likely than fellows to report posting commentary although absolute rate of commentary was low. CONCLUSIONS An asynchronous method of case presentation and online commentary may present an acceptable way to supplement clinical experience and traditional education methods for sharing clinical reasoning.