Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Kraków, Poland.
Medical Education Sciences, Medical School, University of Augsburg, Augsburg, Germany.
Med Teach. 2020 Apr;42(4):457-462. doi: 10.1080/0142159X.2019.1708293. Epub 2020 Feb 4.
Clinical reasoning is a key ability essential for practising health professionals. However, little is known about the current global adoption of clinical reasoning teaching and assessment. We aimed to provide insights into how clinical reasoning is deliberately taught and assessed in curricula worldwide and to identify needs and perceived barriers for teaching clinical reasoning to students and educators. A questionnaire was devised by an international expert group and distributed in a large international medical education community. Data were collected in 2018 and analysed using descriptive statistics. We identified themes in free-text responses using content analysis. Three hundred and thirteen responses from 76 countries were collected. Most respondents were from Europe (34%). While the presence of a longitudinal clinical reasoning curriculum was only reported by 28%, 85% stated that such a curriculum was needed. The lack of awareness of the need to explicitly teach clinical reasoning was the most commonly identified barrier. For assessment, the greatest need identified was for more workplace-based assessment. Global respondents indicate the need to implement explicit longitudinal clinical reasoning curricula. Our findings suggest that efforts should be put into improving faculty development, including evidence-based materials on how to teach and assess clinical reasoning.
临床推理是执业健康专业人员必备的关键能力。然而，目前对于全球临床推理教学和评估的采用情况知之甚少。我们旨在深入了解全球课程中如何有针对性地教授和评估临床推理，并确定学生和教育者教授临床推理的需求和感知障碍。一个国际专家组设计了一份问卷，并在一个大型国际医学教育社区中进行了分发。2018 年收集了数据，并使用描述性统计进行了分析。我们使用内容分析对自由文本回复中的主题进行了识别。从 76 个国家收集了 313 份回复。大多数受访者来自欧洲（34%）。虽然只有 28%的人报告了存在纵向临床推理课程，但 85%的人表示需要这样的课程。最常被确定的障碍是缺乏明确教授临床推理的意识。在评估方面，最大的需求是更多基于工作场所的评估。全球受访者表示需要实施明确的纵向临床推理课程。我们的研究结果表明，应该努力提高教师的发展，包括关于如何教授和评估临床推理的基于证据的材料。
