Clinical Reasoning Workshop: Cervical Spine and Shoulder Disorders

Information processing and cognitive factors may be a cause of physician diagnostic errors. While the conceptual framework of dual processing in clinical reasoning is widely accepted, how can residents be taught to switch between automatic and reflective modes, and will doing so improve their decision making? Developing effective clinical reasoning habits while in training may facilitate progression to expertise, reduce diagnostic errors, and improve patient safety.

This workshop allows residents to practice engaging in and toggling between both modes of information processing using exemplar musculoskeletal vignettes. Originally implemented with a group of 26 physical medicine and rehabilitation residents, the workshop includes pre- and posttests, small-group learning, and a small-group competition.

Posttest scores improved on pretest scores. In an online session evaluation, residents indicated they liked the workshop and thought it improved their diagnostic ability.

This workshop, which includes team- and case-based learning, key features assessment, dual processing theory, and gamification, was effective in engaging residents and resulted in high resident satisfaction and perception of increased ability to tackle clinical problems. Faculty time required was moderate after the initial setup, which in our case primarily involved uploading content into an online learning management system.