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TDG 2008 Report Illness scripts for improving clinical reasoning. Anna Lee, Tony Gin, Charles Gomersall, Warwick Ngan Kee, Gavin Joynt, Anthony Ho, Juliana Chan, Lex Vlantis, James Griffith, William Wong, Coleman Fung. Project objectives.
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TDG 2008 ReportIllness scripts for improving clinical reasoning Anna Lee, Tony Gin, Charles Gomersall, Warwick Ngan Kee, Gavin Joynt, Anthony Ho, Juliana Chan, Lex Vlantis, James Griffith, William Wong, Coleman Fung
Project objectives • To develop and implement a teaching module to improve 4th year medical students’ clinical reasoning skills • To assess students’ level of clinical reasoning skills
Teaching intervention (Feb 2008) • Rotation to 4th year Family Medicine module • Short lecture on clinical reasoning and illness script theory (0.5h) • Small group work on “problem representation” using thinking aloud approach with teacher (1.5h) • Individual guided computer work using clinical reasoning scenarios (1.5h)
Example of clinical reasoning problem • Pull down menus
Deliverables • Developed and debugged a web-based clinical reasoning scoring system using clinical scenarios from University of Queensland that were previously validated against GPs • Developed workshop materials (tutors and students manuals) • Conducted workshop in Feb 2008 • Assessed effectiveness of workshop at end of CFM rotation in April 2008
Clinical reasoning problem score P<0.001
Student feedback with Workshop *1=strongly disagree to 6=strongly agree
Conclusions • Certain aspects of clinical reasoning improved • Identification and interpretation of relevant clinical features and hypothesis generation improved • BUT inconclusive about improving flexibility of thinking and organization of knowledge