Faculty of Medicine, Université de Montréal, Montreal, Canada.
Harvard Medical School, Boston, MA, USA.
Med Teach. 2022 Feb;44(2):158-166. doi: 10.1080/0142159X.2021.1967904. Epub 2021 Aug 29.
The simultaneous integration of knowledge acquisition and development of clinical reasoning in preclinical medical education remains a challenge. To help address this challenge, the authors developed and implemented the Student-Generated Reasoning Tool (SGRT)-a tool asking students to propose and justify pathophysiological hypotheses, generate findings, and critically appraise information.
In 2019, students in a first-year preclinical course ( = 171; SGRT group) were assigned to one of 20 teams. Students used the SGRT individually, then in teams, and faculty provided feedback. The control group ( = 168) consisted of students from 2018 who did not use SGRT. Outcomes included academic performance, effectiveness of collaborative environments using the SGRT, and student feedback.
Students were five times more likely to get questions correct if they were in the SGRT group versus control group. Accuracy of pathophysiological hypotheses was significantly lower for individuals than teams. Qualitative analysis indicated students benefited from generating their own data, justifying their reasoning, and working individually as well as in teams.
This study introduces the SGRT as a potentially engaging, case-based, and collaborative learning method that may help preclinical medical students become aware of their knowledge gaps and integrate their knowledge in basic and clinical sciences in the context of clinical reasoning.
在医学预科教育中,同时进行知识获取和临床推理能力的培养仍然是一个挑战。为了帮助应对这一挑战,作者开发并实施了学生生成推理工具(SGRT),该工具要求学生提出并证明病理生理学假设、生成发现并批判性地评估信息。
2019 年,一门基础医学预科课程的学生( = 171;SGRT 组)被分配到 20 个小组中的一个。学生单独使用 SGRT,然后在团队中使用,教师提供反馈。对照组( = 168)由 2018 年未使用 SGRT 的学生组成。结果包括学业成绩、使用 SGRT 的协作环境的有效性以及学生的反馈。
如果学生在 SGRT 组,他们答对问题的可能性是对照组的五倍。个人提出的病理生理学假设的准确性明显低于团队。定性分析表明,学生从生成自己的数据、证明自己的推理以及单独和团队工作中受益。
本研究介绍了 SGRT,它是一种潜在引人入胜的、基于案例的协作学习方法,可能有助于医学预科学生意识到自己的知识差距,并在临床推理的背景下整合基础和临床科学知识。