Assessment of Clinical Reasoning and Diagnostic Thinking Among Dental Students

Abstract

Aim and background: Diagnostic thinking is the ultimate goal of educational system and the basis for clinical reasoning. The aim of this study was to assess the clinical reasoning and diagnostic thinking ability of dental students by key features test and Diagnostic thinking inventory (DTI) questionnaire. Materials and methods The present study was a descriptive cross-sectional study. The participants consisted of 61 senior dental students. Clinical reasoning and diagnostic thinking were assessed by key feature test and DTI questionnaire, respectively. To design the KF test questions, the blueprint of exam was first designed in expert panel based on dental curriculum. The questions developed based on common cases in oral and maxillofacial diseases by the group of oral and maxillofacial specialists. The DTI was developed by Bourdieu et al. in France and consists of 41 questions on a 6-point Likert scale, of which 21 are memory structure category and 20 are in flexibility in thinking category. Satisfaction of student assessed through a 10-item questionnaire. Data were analyzed using SPSS 19 by descriptive tests (mean, SD, percentage) and student independent T-test and Pearson test. Significance level was determined p < 0.05. Results The mean scores of the key features test of students were 56.55 ± 7.80. No significant difference was reported between clinical reasoning scores of key features test by students' gender (p-value = 0.19). There was no significant difference between the scores of diagnostic thinking between men and women (p-value = 0.11). The difference in students' scores in the domain of flexibility in thinking was significantly higher among male students than female students. (P-value = 0.04). There was no significant correlation between students' diagnostic thinking scores and their clinical reasoning scores in the key features test. Conclusion Based on the present results, the clinical reasoning and diagnostic thinking skills of participants were reported in the low level. This issue emphasizes the need for training to enhance diagnostic thinking and clinical reasoning in dental education. Formative evaluation and reform the educational programs of this course should be considered.

Critical Thinking, Clinical Reasoning Skills and Cognitive Abilities of Dental Students

“…47 A single report on the use of DTI in dental students compared the results of clinical reasoning skills measurement between DTI and Key Feature tests (KFt), a class assessment method. 27 Keshmiri et al 27 reported that DTI has a similar ability to KFt in measuring the clinical reasoning skills of senior dental students. The DTI could assess the flexibility in thinking and structure of knowledge in memory independent of content and can evaluate different levels of medical students.…”

“…23 Clinical reasoning skills are mostly related to diagnostic thinking and are commonly observed quantitatively by class or clinical assessment methods. [26][27][28][29] However, some standardized instruments are known to be able to assess reasoning skills, for example, Diagnostic Thinking Processes (DTP) and Diagnostic Thinking Inventory (DTI). 27,[30][31][32] Cognitive ability refers to mental processes for problem-solving, through discrimination, analyzing, predicting, reasoning, information seeking, and transforming knowledge.…”

“…[26][27][28][29] However, some standardized instruments are known to be able to assess reasoning skills, for example, Diagnostic Thinking Processes (DTP) and Diagnostic Thinking Inventory (DTI). 27,[30][31][32] Cognitive ability refers to mental processes for problem-solving, through discrimination, analyzing, predicting, reasoning, information seeking, and transforming knowledge. 33 Cognitive ability is the problem-solving skill with success determined by knowledge.…”

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

“…SOE can test clinical reasoning skills and knowledge in numerous categories that can be applied to different levels of medical students [ 14 ]. It is believed that DTI can evaluate flexibility in thinking and memory structure at various levels of clinical experience [ 12 , 15 ].…”