Clinical Reasoning Terms Included in Clinical Problem Solving Exercises?

Area of Science:

• Medical Education
• Clinical Reasoning
• Cognitive Science

Background:

• Published clinical problem-solving exercises are common tools for illustrating clinical reasoning.
• The specific clinical reasoning terms used in these exercises are not well-documented.
• Understanding the alignment between educator priorities and published terminology is crucial for effective training.

Purpose of the Study:

• To identify clinical reasoning terms used in published exercises.
• To compare these terms with those prioritized by clinician educators.
• To inform the development of a standardized nomenclature for clinical reasoning education.

Main Methods:

• Clinician educators ranked a list of clinical reasoning terms by importance.
• A systematic electronic search was conducted for these terms in internal medicine journal reports (2010-2013).
• The frequency of term usage in 79 published reports was analyzed.

Main Results:

• Educators prioritized dual-process thinking, problem representation, and illness scripts.
• Published reports most frequently mentioned context specificity, bias, and dual-process thinking.
• Some highly prioritized terms were not found in publications, while others were used without high educator ranking.

Conclusions:

• While some core clinical reasoning concepts are present in published exercises, there is a discrepancy between educator priorities and actual usage.
• The study highlights a need for a unified terminology to enhance the teaching of clinical reasoning.
• Standardizing clinical reasoning terms can improve educational efforts for trainees.