Department of Oral Medicine, Faculty of Dentistry, Universitas Gadjah Mada, Jl. Denta 1, Sekip Utara, Yogyakarta 55281, Indonesia.
BMC Med Educ. 2023 Jan 23;23(1):52. doi: 10.1186/s12909-022-03808-7.
Health professionals are known to use various combinations of knowledge and skills, such as critical thinking, clinical reasoning, clinical judgment, problem-solving, and decision-making, in conducting clinical practice. Clinical reasoning development is influenced by knowledge and experience, the more knowledge and experience, the more sophisticated clinical reasoning will be. However, clinical reasoning research in dentistry shows varying results .
This study aims to observe the clinical reasoning pattern of undergraduate dental students when solving oral health problems, and their accordance with their knowledge acquisition.
This qualitative study employed the think-aloud method and the result was assessed through verbal protocol analyses. Five respondents from final year dental undergraduate students were agreed to participate. A unique hypothetical clinical scenario was used as a trigger. The audio data were transcribed, interpreted, and categorized as a clinical reasoning pattern; and the concept maps created were assessed by a Structure of Learning Outcomes (SOLO) taxonomy as knowledge acquisition.
Observations on clinical reasoning patterns and the level of knowledge acquisition in five undergraduate dental students showed varying results. They applied clinical reasoning patterns according to their knowledge acquisition during didactical phase. Learners with inadequate knowledge relied on guessing, meanwhile learners with adequate knowledge applied more sophisticated reasoning pattern when solving problems.
Various problem-solving strategies were encountered in this study, which corresponded to the level of knowledge acquisition. Dental institutions must set minimum standards regarding the acquisition of conceptual knowledge accompanied by improvement of clinical reasoning skills, as well as refinement of knowledge and procedural skills.
众所周知，医疗专业人员在进行临床实践时会运用各种知识和技能的组合，如批判性思维、临床推理、临床判断、问题解决和决策制定。临床推理的发展受到知识和经验的影响，知识和经验越多，临床推理就越复杂。然而，牙科领域的临床推理研究结果却各不相同。
本研究旨在观察本科牙科学生在解决口腔健康问题时的临床推理模式及其与知识获取的一致性。
本定性研究采用了出声思维法，通过言语报告分析进行评估。从牙科本科应届毕业生中选取了 5 名受访者参与研究。采用独特的假设临床情景作为触发因素。对音频数据进行转录、解释和分类，形成临床推理模式；并使用学习成果结构（SOLO）分类法对创建的概念图进行评估，以了解知识获取情况。
对 5 名本科牙科学生的临床推理模式和知识获取水平的观察结果显示出不同的结果。在教学阶段，他们根据自己的知识获取应用了不同的临床推理模式。知识储备不足的学习者依赖猜测，而知识储备充足的学习者在解决问题时则应用了更复杂的推理模式。
本研究中遇到了各种问题解决策略，这些策略与知识获取水平相对应。牙科机构必须设定最低标准，要求学生在获得概念知识的同时，提高临床推理技能，并完善知识和程序技能。
