Department of Academic Technology, University of Wisconsin, Madison, Wisconsin.
Department of Kinesiology, University of Wisconsin, Madison, Wisconsin.
Anat Sci Educ. 2022 Mar;15(2):304-316. doi: 10.1002/ase.2050. Epub 2021 Mar 11.
Clinically integrated curricula in health science education has been shown to promote the development of problem-solving schema and positively impact knowledge acquisition. Despite its' purported benefits, this type of curricula can impose a high cognitive load, which may negatively impact novice learners' knowledge acquisition and problem-solving schema development. Introducing explicit clinical reasoning instruction within pre-professional undergraduate basic science courses may limit factors that increase cognitive load, enhance knowledge acquisition, and foster developing clinical problem-solving skills. This study, conducted over the Fall and Spring semesters of the 2018-2019 school year, sought to evaluate whether the implementation of a clinical reasoning instructional intervention within a clinically integrated pre-professional undergraduate general human anatomy course influenced students' acquisition of anatomical knowledge and development of clinical problem-solving skills. Results of the study were mixed regarding the acquisition of anatomical knowledge. Both the intervention and comparison groups performed similarly on multiple choice examinations of anatomical knowledge. However, the clinical reasoning intervention positively impacted students' ability to apply clinical reasoning skills to anatomically based clinical case studies. Results from M\mixed between-within subjects analysis of variance comparing scores on Written Clinical Reasoning Assessments revealed a significant interaction between time and group affiliation, with the groups receiving the interventions outperforming the comparison groups: Fall, P < 0.001; Spring, P < 0.001. The results of this study may imply that explicit clinical reasoning instruction within a clinically integrated undergraduate Human Anatomy course could hold potential for fostering students' early clinical reasoning skills.
在健康科学教育中，临床综合课程已被证明可以促进问题解决模式的发展，并对知识获取产生积极影响。尽管有其好处，但这种课程可能会带来很高的认知负担，从而对新手学习者的知识获取和问题解决模式的发展产生负面影响。在本科基础科学课程中引入明确的临床推理教学，可以限制增加认知负担的因素，提高知识获取，并培养临床问题解决技能。本研究于 2018-2019 学年的秋季和春季学期进行，旨在评估在临床综合本科普通人体解剖学课程中实施临床推理教学干预是否会影响学生对解剖学知识的掌握和临床问题解决技能的发展。关于解剖学知识的获取，研究结果喜忧参半。干预组和对照组在多项解剖学知识的选择题考试中表现相似。然而，临床推理干预对学生将临床推理技能应用于基于解剖的临床病例研究的能力产生了积极影响。对书面临床推理评估分数进行的混合主体间方差分析的结果表明，时间和组隶属关系之间存在显著的交互作用，接受干预的组比对照组表现更好：秋季，P<0.001；春季，P<0.001。这项研究的结果可能表明，在临床综合本科人体解剖学课程中引入明确的临床推理教学可能有助于培养学生的早期临床推理技能。
