Design and delivery of a new clinical reasoning course

Teaching students therapeutic knowledge is not the same as teaching them how to reason through clinical problems. It was determined a new approach was necessary to close the gap between classroom learning and clinical application.

A stand-alone clinical reasoning course was developed to enhance students' ability to think about and solve clinical problems. This course involved a variety of active-learning strategies based upon literature regarding clinical reasoning.

The objective of this study was to determine if a clinical reasoning course influenced student perceptions on evolution of their thinking and learning strategies and ways to improve. Thematic analysis of midpoint student reflections (n = 133) revealed eight different themes of how students perceived evolution of their thinking. Top themes were approaching a problem (n = 76), evaluating information (n = 62), and efficiency (n = 44). Thematic analysis of final student reflections (n = 138) included two categories: thinking and improvement. Reflections related to evolvement of thinking revealed five themes, the top three of which were approaching a problem (n = 89), holistic (n = 55), and efficiency (n = 46). Reflections of improvement revealed four themes, the top two of which were continue applying (n = 74) and communication (n = 23).

The themes indicate that students began to understand clinical reasoning as a set of skills necessary to become an effective practitioner.

A novel course designed to develop clinical reasoning skills can help students evolve their perception of thinking and learning strategies and engage them in a process for the application of knowledge to patient care.