research and the teaching and learning of clinical...
TRANSCRIPT
Research and the teaching and learning of clinical
reasoning: where do we start?RK McKinley
The plan…• Introductions 10 min• ‘State of the art’ 10 min• Group work 1 25 min
– A question• Feedback 10 min• Group work 2 25 min
– A plan• Windup 10 min
Introductions• Who I am• Why I am here• What I am interested in
– ‘Know more’to
– ‘I have an idea’
Where do we start?• ‘State’ of the art
– Methodologies– Questions
State of the art• Search
– Medical education OR Medical teacher OR Academic medicine OR Advances in health sciences education
– AND – [MeSH Major Topic]
• Clinical Decision-Making – OR – Text word
• "clinical reasoning“ OR "diagnostic reasoning“ OR "diagnostic thinking“ OR "clinical thinking"
Results: 356 papers
0
5
10
15
20
25
30
35
Count papers per year
Results: 2016-17 methodsMethodology 2016 2017Experimental 1 7Qualitative 1.5 3Pedagogy 2 3Assessment 2 2Theoretical 1 1Descriptive 1.5 2Neuroimaging 3
Experimental studies• Pre-test probabilities on decision making• Compulsory vs self-directed use of VPs and NBME
scores• Impact of representation scaffolds• Self explanation vs no self explanation • Emphasising concepts vs applications• Self explanation vs integrated teaching vs basic science• Cognitive load in immersive simulation and SP• Effect of KFP+VP vs VP only
Qualitative• Does thinking when doing MCQ’s parallel clinical
thinking• Complex clinical judgements• What doctors think about during admissions• Residents thinking• (Context errors in clinical reasoning)
Descriptive• Development of clinical reasoning using large data sets• Analysis of progress test results• Scoring patient notes from SP encounters• (Context errors in clinical reasoning)
Assessment• Validity of script concordance• Comparison examination formats SMA vs KFP• Self-regulated learning analysis of clinical tasks• Scoring written case summaries
Research
How good are we?
Local only
‘Private’
New knowledge
‘Public’
Generalisable
Evaluation Research
Research• Theory• Rigor• Scope
• Role of description
Reflections on the room• Range
– People– Institutions– Pedagogies
• Opportunities– Collaboration– Scale– Synergy
Small groups• Tables by themes
– A question
Feedback• The question is …
Small groups• Tables by question
– A (sketch) plan
Windup
Research and the teaching and learning of clinical reasoning: where do we start?
HERE!!
Questions• Pedagogy of clinical reasoning: state of
the art in the UK• Assessment of clinical reasoning: state of
the art in the UK• Can clinical reasoning be taught?