A workshop to train medicine faculty to teach clinical reasoning

Abstract

Background Clinical reasoning (CR) is a core competency in medical education. Few studies have examined efforts to train faculty to teach CR and lead CR curricula in medical schools and residencies. In this report, we describe the development and preliminary evaluation of a faculty development workshop to teach CR grounded in CR theory. Methods Twenty-six medicine faculty (nine hospitalists and 17 subspecialists) participated in a workshop that introduced a framework to teach CR using an interactive, case-based didactic followed by role-play exercises. Faculty participated in pre- and post-Group Observed Structured Teaching Exercises (GOSTE), completed retrospective pre-post assessments (RPPs), and made commitment to change statements (CTCs). Results In the post-GOSTE, participants significantly improved in their use of problem representation and illness scripts to teach CR. RPPs revealed that faculty were more confident in their ability and more likely to teach CR using educational strategies grounded in CR educational theory. At 2-month follow-up, 81% of participants reported partially implementing these teaching techniques. Conclusions After participating in this 3-h workshop, faculty demonstrated increased ability to use these teaching techniques and expressed greater confidence and an increased likelihood to teach CR. The majority of faculty reported implementing these newly learned educational strategies into practice.

Clinical reasoning education in the clerkship years: A cross-disciplinary national needs assessment

“…For example, in our study problem representation and illness scripts were identified as the most important concepts to teach in clinical clerkships. In a faculty development study, a single case-based, interactive workshop followed by role-play exercises resulted in significant improvement in faculty’s use of problem representation and illness scripts when teaching [ 21 ].…”

Clinical reasoning training sessions for health educators—A scoping review

“…The CR training sessions for the undergraduate healthcare profession were categorized into sessions to train and guide educators regarding the domains of CR education, 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 and sessions to guide educators in how to use a newly developed tool 28 , 29 or mobile application 30 to facilitate CR education. These sessions were conducted either as stand-alone sessions 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 or as an independent topic in a series of faculty development programs. 19 , 20 These training sessions had similar aims of guiding and training educators in CR to empower them in their teaching.…”

“… 19 , 20 These training sessions had similar aims of guiding and training educators in CR to empower them in their teaching. Specifically, these training sessions were aimed at providing guidance in the cognitive steps and CR framework 21 , 22 , 25 , 26 , 27 ; diagnostic error and bias 24 ; and identification of learners with CR difficulties. 23 , 30 …”

“…Problem identification 25 and related data collection 21 were among the initial steps in CR that were a focus in the training sessions. The educators were subsequently introduced to the concept of problem representation, 21 , 26 , 29 i.e., a detailed summary of relevant clinical information. Educators were encouraged to use semantic qualifiers—i.e., opposing clinical terms, such as acute and chronic, or unilateral and bilateral—in the problem representation.…”

Development of a Clinical Reasoning Documentation Assessment Tool for Resident and Fellow Admission Notes: a Shared Mental Model for Feedback

“…This group had expertise in assessment and feedback and development of clinical reasoning curricula across the educational continuum-undergraduate medical education, graduate medical education, and faculty development. [24][25][26] This panel iteratively reviewed the assessment and plans of randomly selected de-identified admission notes from the NYU Langone EHR written by internal medicine residents and medicine subspecialty fellows using the IDEA assessment tool core domains. To help ensure the selected notes were diagnostic in nature rather than more management related, pre-procedure notes and admission notes written after 3 days of the admitting date were excluded.…”