Center for Educational Research in Medical Education, Medical Education Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Roosevelt Center for Excellence in Education, University College Roosevelt, Utrecht University, Middelburg, The Netherlands.
PLoS One. 2024 Oct 16;19(10):e0309606. doi: 10.1371/journal.pone.0309606. eCollection 2024.
Clinical reasoning involves the application of knowledge and skills to collect and integrate information, typically to arrive at a diagnosis, implement appropriate interventions, solve clinical problems, and improve the quality of health care and patient outcomes. It is a vital competency that medical students must acquire, as it is considered the heart of medicine.
This scoping review aimed to identify and summarize the existing literature on learning and teaching strategies for improving clinical reasoning skill in undergraduate medical education.
We conducted electronic searches in Scopus, PubMed/Medline (NLM), Web of Science (WOS), and ERIC to retrieve articles published between January 1, 2010, and March 23, 2024. We also performed hand searches by scanning the reference lists of included studies and similar reviews and searching three key journals. After removing duplicates, two reviewers independently extracted data from primary articles using a standard data extraction form. The authors used Arksey and O'Malley's framework.
Among the 46581 retrieved records, 54 full-text articles were included in the present review. We categorized the educational strategies based on their aspects, focus, and purpose. Included studies used various educational strategies for improving clinical reasoning skill in undergraduate medical education by serial cue or whole clinical cases that presented as process-oriented or knowledge-oriented.
This scoping review investigated various dimensions of educational intervention for improving clinical reasoning skill in undergraduate medical education. There is a need for more precision studies with larger sample sizes, designing studies according to randomized controlled trials standards, determining MCID, or performing meta-analyses to acquire robust and conclusive results.
临床推理涉及应用知识和技能来收集和整合信息，通常是为了做出诊断、实施适当的干预措施、解决临床问题、提高医疗质量和改善患者预后。这是医学生必须掌握的一项重要能力，因为它被认为是医学的核心。
本范围综述旨在确定和总结现有的文献，以了解和教学策略，以提高本科医学教育中的临床推理技能。
我们在 Scopus、PubMed/Medline（NLM）、Web of Science（WOS）和 ERIC 中进行了电子检索，以检索 2010 年 1 月 1 日至 2024 年 3 月 23 日期间发表的文章。我们还通过扫描纳入研究和类似综述的参考文献列表以及搜索三个主要期刊来进行手工搜索。在删除重复项后，两名审查员使用标准数据提取表独立从主要文章中提取数据。作者使用了 Arksey 和 O'Malley 的框架。
在 46581 条检索记录中，有 54 篇全文文章被纳入本综述。我们根据教育策略的方面、重点和目的对其进行了分类。纳入的研究使用了各种教育策略来提高本科医学教育中的临床推理技能，包括通过连续线索或整个临床病例来呈现以过程为导向或以知识为导向的策略。
本范围综述调查了本科医学教育中提高临床推理技能的各种教育干预维度。需要更多的精确研究，样本量更大，根据随机对照试验标准设计研究，确定 MCID，或进行荟萃分析，以获得稳健和结论性的结果。
