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Exploring Differences in Clinical Decisions Between Medical Students and Expert Clinicians.

Marcos Rojas1, Argenta Price2, Candice Jeehae Kim1,3

  • 1Graduate School of Education, Stanford University, Stanford, California, USA.

Advances in Medical Education and Practice
|December 30, 2024
PubMed
Summary
This summary is machine-generated.

Expert clinicians and medical students differ in clinical reasoning practices and decisions. Identifying these differences can improve medical education and assessment tools for better clinical reasoning development in students.

Keywords:
clinical decisionsclinical problem-solvingclinical reasoningclinical reasoning practicedecision making

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Area of Science:

  • Medical Education
  • Cognitive Science
  • Learning Sciences

Background:

  • Challenges persist in integrating clinical reasoning theory and practice in medical education.
  • Existing theoretical models of clinical reasoning often lack practical application in teaching and assessment.
  • This study addresses the gap by comparing clinical reasoning in students and experts using a problem-solving framework.

Purpose of the Study:

  • To compare clinical reasoning practices and decisions between medical students and expert clinicians.
  • To identify specific differences in the diagnostic process between these groups.
  • To provide a framework for improving clinical reasoning instruction.

Main Methods:

  • A questionnaire based on a learning sciences problem-solving framework was developed for a pediatric infectious disease case.
  • Data were collected from 10 expert clinicians and 74 medical students at Stanford University (2019-2023).
  • Deductive content analysis was used to code responses and identify patterns in clinical reasoning practices and decisions.

Main Results:

  • A detailed framework of clinical reasoning was empirically developed, comprising nine practices and twenty-nine decisions.
  • Significant differences between experts and students were observed in ten key decisions across four practices.
  • These practices included differential diagnosis formulation, diagnostic plan execution, data reassessment, and solution review.

Conclusions:

  • Nuanced differences in clinical reasoning between medical students and expert physicians were identified within a unified problem-solving framework.
  • Understanding these differences can inform the development of targeted instructional materials and assessment tools.
  • This research aids educators in fostering essential clinical reasoning skills in medical trainees.