Diagnosis and management of clinical reasoning difficulties: Part I. Clinical reasoning supervision and educational diagnosis

Abstract

There are many obstacles to the timely identification of clinical reasoning difficulties in health professions education. This guide aims to provide readers with a framework for supervising clinical reasoning and identifying the potential difficulties as they may occur at each step of the reasoning process.

Perceptions of Clinical Supervision in Ambulatory Settings: Do Supervisee and Supervisors See Eye to Eye?

“…These results could be interpreted as a call to improve skills in intervening and supporting students as they struggle to acquire clinical reasoning skills. These skills would support adoption of a professional approach to teaching rather than the intuitive approach that appears to be reflected in these findings as well as in other results (Atkinson, Ajjawi, & Cooling, 2011;Audétat, Laurin, Dory, Charlin, & Nendaz, 2017). It is also worth reporting that both supervisors and students score themselves low on the exploration dimension.…”

Clinical reasoning – an approach for decision-making in education and training for biomedical scientists

“…Diagnostic errors can also happen in these cases where there is no consistent inclusion of standard knowledge in the decision-making process [30], [31]. Focus can be placed specifically on the possibility of errors when teaching CR at more advanced levels of education [32], [33]. The differentiated development and fostering of the forms of reasoning during all educational phases, including further education could contribute to balancing and successfully synthesizing different sources of knowledge and decision-making processes.…”

Using theory to interpret how senior clinicians define, learn, and teach clinical reasoning

“…Even though they continue to use an apprenticeship model to teach clinical reasoning to their students, the learning points they emphasised are consonant with the recommendations in the medical education literature underpinned by dual process theory (eg. Audétat et al 2017, Norman et al 2017 and script theory (eg. Lubarsky et at 2015, Schmidt & Mamede 2015.…”

“…'recognising the pitfalls of fast thinking' was interpreted to make a direct reference to a principle of dual process theory (Audétat et al 2017, Norman et al 2017. Other learning points were interpreted from a script theory perspective to provide insights into how illness scripts can become elaborated and interconnected.…”

“…The fast process is regarded as non-analytical and spontaneous, whereas, the slow process is analytical, deliberate, and underpins our hypothetical-deductive reasoning ability. Dual process theory has been used to identify students' diagnostic difficulties and suggested possible remediation techniques such as teaching them about the possible sources of errors and biases in their clinical reasoning (Audétat et al 2017, Norman et al 2017. Dual process theory appears to be useful when examining students' challenges when learning clinical reasoning.…”