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Promoting student case creation to enhance instruction of clinical reasoning skills: a pilot feasibility study

BACKGROUND: It is a common educational practice for medical students to engage in case-based learning (CBL) exercises by working through clinical cases that have been developed by faculty. While such faculty-developed exercises have educational strengths, there are at least two major drawbacks to le...

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Autores principales: Chandrasekar, Hamsika, Gesundheit, Neil, Nevins, Andrew B, Pompei, Peter, Bruce, Janine, Merrell, Sylvia Bereknyei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903478/
https://www.ncbi.nlm.nih.gov/pubmed/29692641
http://dx.doi.org/10.2147/AMEP.S155481
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author Chandrasekar, Hamsika
Gesundheit, Neil
Nevins, Andrew B
Pompei, Peter
Bruce, Janine
Merrell, Sylvia Bereknyei
author_facet Chandrasekar, Hamsika
Gesundheit, Neil
Nevins, Andrew B
Pompei, Peter
Bruce, Janine
Merrell, Sylvia Bereknyei
author_sort Chandrasekar, Hamsika
collection PubMed
description BACKGROUND: It is a common educational practice for medical students to engage in case-based learning (CBL) exercises by working through clinical cases that have been developed by faculty. While such faculty-developed exercises have educational strengths, there are at least two major drawbacks to learning by this method: the number and diversity of cases is often limited; and students decrease their engagement with CBL cases as they grow accustomed to the teaching method. We sought to explore whether student case creation can address both of these limitations. We also compared student case creation to traditional clinical reasoning sessions in regard to tutorial group effectiveness, perceived gains in clinical reasoning, and quality of student–faculty interaction. METHODS: Ten first-year medical students participated in a feasibility study wherein they worked in small groups to develop their own patient case around a preassigned diagnosis. Faculty provided feedback on case quality afterwards. Students completed pre- and post-self-assessment surveys. Students and faculty also participated in separate focus groups to compare their case creation experience to traditional CBL sessions. RESULTS: Students reported high levels of team engagement and peer learning, as well as increased ownership over case content and understanding of clinical reasoning nuances. However, students also reported decreases in student–faculty interaction and the use of visual aids (P < 0.05). CONCLUSION: The results of our feasibility study suggest that student-generated cases can be a valuable adjunct to traditional clinical reasoning instruction by increasing content ownership, encouraging student-directed learning, and providing opportunities to explore clinical nuances. However, these gains may reduce student–faculty interaction. Future studies may be able to identify an improved model of faculty participation, the ideal timing for incorporation of this method in a medical curriculum, and a more rigorous assessment of the impact of student case creation on the development of clinical reasoning skills.
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spelling pubmed-59034782018-04-24 Promoting student case creation to enhance instruction of clinical reasoning skills: a pilot feasibility study Chandrasekar, Hamsika Gesundheit, Neil Nevins, Andrew B Pompei, Peter Bruce, Janine Merrell, Sylvia Bereknyei Adv Med Educ Pract Original Research BACKGROUND: It is a common educational practice for medical students to engage in case-based learning (CBL) exercises by working through clinical cases that have been developed by faculty. While such faculty-developed exercises have educational strengths, there are at least two major drawbacks to learning by this method: the number and diversity of cases is often limited; and students decrease their engagement with CBL cases as they grow accustomed to the teaching method. We sought to explore whether student case creation can address both of these limitations. We also compared student case creation to traditional clinical reasoning sessions in regard to tutorial group effectiveness, perceived gains in clinical reasoning, and quality of student–faculty interaction. METHODS: Ten first-year medical students participated in a feasibility study wherein they worked in small groups to develop their own patient case around a preassigned diagnosis. Faculty provided feedback on case quality afterwards. Students completed pre- and post-self-assessment surveys. Students and faculty also participated in separate focus groups to compare their case creation experience to traditional CBL sessions. RESULTS: Students reported high levels of team engagement and peer learning, as well as increased ownership over case content and understanding of clinical reasoning nuances. However, students also reported decreases in student–faculty interaction and the use of visual aids (P < 0.05). CONCLUSION: The results of our feasibility study suggest that student-generated cases can be a valuable adjunct to traditional clinical reasoning instruction by increasing content ownership, encouraging student-directed learning, and providing opportunities to explore clinical nuances. However, these gains may reduce student–faculty interaction. Future studies may be able to identify an improved model of faculty participation, the ideal timing for incorporation of this method in a medical curriculum, and a more rigorous assessment of the impact of student case creation on the development of clinical reasoning skills. Dove Medical Press 2018-04-12 /pmc/articles/PMC5903478/ /pubmed/29692641 http://dx.doi.org/10.2147/AMEP.S155481 Text en © 2018 Chandrasekar et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Chandrasekar, Hamsika
Gesundheit, Neil
Nevins, Andrew B
Pompei, Peter
Bruce, Janine
Merrell, Sylvia Bereknyei
Promoting student case creation to enhance instruction of clinical reasoning skills: a pilot feasibility study
title Promoting student case creation to enhance instruction of clinical reasoning skills: a pilot feasibility study
title_full Promoting student case creation to enhance instruction of clinical reasoning skills: a pilot feasibility study
title_fullStr Promoting student case creation to enhance instruction of clinical reasoning skills: a pilot feasibility study
title_full_unstemmed Promoting student case creation to enhance instruction of clinical reasoning skills: a pilot feasibility study
title_short Promoting student case creation to enhance instruction of clinical reasoning skills: a pilot feasibility study
title_sort promoting student case creation to enhance instruction of clinical reasoning skills: a pilot feasibility study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903478/
https://www.ncbi.nlm.nih.gov/pubmed/29692641
http://dx.doi.org/10.2147/AMEP.S155481
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