Teaching and Assessment of Clinical Reasoning Skills in a Case-Based Veterinary Cardiology Elective

Clinical reasoning (CR) is an important clinical competency for effective veterinary practice. We hypothesized that implementing an explicit 7-week CR curriculum taught in a large-enrollment elective veterinary cardiology course would improve students' awareness of clinical reasoning principles, self-efficacy of CR skills, and application of CR principles in clinical case analyses. A secondary aim was to assess the impact of peer review as a means of providing feedback in a large classroom setting. A mixed method approach was used with veterinary students (N = 78) in a cardiology elective course meeting twice weekly for a half-semester (7 weeks). Course content included a 1-week introduction to CR led by the instructor and 6 weeks of instructor-facilitated, case-based learning. Quantitative and qualitative data were collected, including pre- and post-course surveys, weekly peer reviews for six clinical case assignments, and instructor-graded clinical cases for three case assignments. Students reported improved self-efficacy across all CR skill categories (p < .001) and significant improvement in applied CR skills was demonstrated in both peer- (p < .001) and instructor-graded assignments (p < .001). Peer reviews provided a means for students to reflect on and internalize CR skills, which may play a role in improved self-efficacy. In an elective cardiology course, implementing an explicit CR curriculum resulted in improved student awareness and self-efficacy of CR, as well as improved applied CR skills.