Benoît Stéphanie, Bouchard-Lamothe Diane, Denis-Leblanc Manon, Burnier Isabelle
Département de médecine familiale, Faculté de médecine, Université d'Ottawa, Ontario, Canada.
Affaires francophones, Faculté de médecine, Université d'Ottawa, Ontario, Canada.
Can Med Educ J. 2025 May 1;16(2):38-42. doi: 10.36834/cmej.77080. eCollection 2025 May.
Learning clinical reasoning (CR) requires practice in a variety of educational settings. As part of the clinical simulation sessions at the University of Ottawa's Faculty of Medicine, pre-clerkship students are paired in dyads to increase the number of practical clinical cases before the clerkship. One student plays the role of a Clinical Student (CS) and the other alternates as a Student Observer (SO). This quantitative descriptive study aims to compare the diagnostic hypothesis generation by SOs with that of CSs to support the usefulness of engaged peer observation as a CR learning strategy in clinical simulation settings.
Following an interview with a simulated patient, CSs and SOs were asked to generate two diagnostic hypotheses in an electronic form. Responses were compiled, categorized, and compared in terms of equivalent diagnostic hypotheses within the same dyad. The difference in frequency distribution of equivalent hypotheses was statistically analyzed using a chi-square calculation.
The percentage of dyads with at least one equivalent diagnostic hypothesis ranged from 83% to 100%, depending on the scenario. The number of equivalent hypotheses between SOs and CSs was statistically significant ( < 0.01).
SOs appear to be able to generate diagnostic hypotheses similar to those of CSs. The results support the use of engaged peer observation as a learning strategy for CR in clinical simulation settings in pre-clerkship medical education.
学习临床推理(CR)需要在多种教育环境中进行实践。作为渥太华大学医学院临床模拟课程的一部分,见习前的学生两两配对,以增加见习前实际临床病例的数量。一名学生扮演临床学生(CS)的角色,另一名学生交替扮演学生观察者(SO)。这项定量描述性研究旨在比较学生观察者(SO)和临床学生(CS)生成诊断假设的情况,以支持在临床模拟环境中进行同伴参与观察作为一种CR学习策略的有效性。
在与模拟患者进行访谈后,要求临床学生(CS)和学生观察者(SO)以电子形式生成两个诊断假设。对回答进行整理、分类,并在同一配对中就等效诊断假设进行比较。使用卡方计算对等效假设的频率分布差异进行统计分析。
根据不同场景,至少有一个等效诊断假设的配对比例在83%至100%之间。学生观察者(SO)和临床学生(CS)之间等效假设的数量具有统计学意义(<0.01)。
学生观察者(SO)似乎能够生成与临床学生(CS)相似的诊断假设。研究结果支持在医学教育见习前阶段的临床模拟环境中,将同伴参与观察作为临床推理(CR)的一种学习策略。