Observable phenomena that reveal medical students' clinical reasoning ability during expert assessment of their history taking: a qualitative study
Abstract Background During their clerkships, medical students are meant to expand their clinical reasoning skills during their patient encounters. Observation of these encounters could reveal important information on the students’ clinical reasoning abilities, especially during history taking. Metho...
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| Format: | Article |
| Language: | English |
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BMC
2017-08-01
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| Series: | BMC Medical Education |
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| Online Access: | http://link.springer.com/article/10.1186/s12909-017-0983-3 |
| _version_ | 1818873563451490304 |
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| author | Catharina M. Haring Bernadette M. Cools Petra J. M. van Gurp Jos W. M. van der Meer Cornelis T. Postma |
| author_facet | Catharina M. Haring Bernadette M. Cools Petra J. M. van Gurp Jos W. M. van der Meer Cornelis T. Postma |
| author_sort | Catharina M. Haring |
| collection | DOAJ |
| description | Abstract Background During their clerkships, medical students are meant to expand their clinical reasoning skills during their patient encounters. Observation of these encounters could reveal important information on the students’ clinical reasoning abilities, especially during history taking. Methods A grounded theory approach was used to analyze what expert physicians apply as indicators in their assessment of medical students’ diagnostic reasoning abilities during history taking. Twelve randomly selected clinical encounter recordings of students at the end of the internal medicine clerkships were observed by six expert assessors, who were prompted to formulate their assessment criteria in a think-aloud procedure. These formulations were then analyzed to identify the common denominators and leading principles. Results The main indicators of clinical reasoning ability were abstracted from students’ observable acts during history taking in the encounter. These were: taking control, recognizing and responding to relevant information, specifying symptoms, asking specific questions that point to pathophysiological thinking, placing questions in a logical order, checking agreement with patients, summarizing and body language. In addition, patients’ acts and the course, result and efficiency of the conversation were identified as indicators of clinical reasoning, whereas context, using self as a reference, and emotion/feelings were identified by the clinicians as variables in their assessment of clinical reasoning. Conclusions In observing and assessing clinical reasoning during history taking by medical students, general and specific phenomena to be used as indicators for this process could be identified. These phenomena can be traced back to theories on the development and the process of clinical reasoning. |
| first_indexed | 2024-12-19T12:56:42Z |
| format | Article |
| id | doaj.art-479940920645479eaa0b03b07ca33c04 |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-12-19T12:56:42Z |
| publishDate | 2017-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj.art-479940920645479eaa0b03b07ca33c042022-12-21T20:20:22ZengBMCBMC Medical Education1472-69202017-08-011711910.1186/s12909-017-0983-3Observable phenomena that reveal medical students' clinical reasoning ability during expert assessment of their history taking: a qualitative studyCatharina M. Haring0Bernadette M. Cools1Petra J. M. van Gurp2Jos W. M. van der Meer3Cornelis T. Postma4Department of Internal Medicine (463), Radboud University Medical CenterDepartment of Internal Medicine (463), Radboud University Medical CenterDepartment of Internal Medicine (463), Radboud University Medical CenterDepartment of Internal Medicine (463), Radboud University Medical CenterDepartment of Internal Medicine (463), Radboud University Medical CenterAbstract Background During their clerkships, medical students are meant to expand their clinical reasoning skills during their patient encounters. Observation of these encounters could reveal important information on the students’ clinical reasoning abilities, especially during history taking. Methods A grounded theory approach was used to analyze what expert physicians apply as indicators in their assessment of medical students’ diagnostic reasoning abilities during history taking. Twelve randomly selected clinical encounter recordings of students at the end of the internal medicine clerkships were observed by six expert assessors, who were prompted to formulate their assessment criteria in a think-aloud procedure. These formulations were then analyzed to identify the common denominators and leading principles. Results The main indicators of clinical reasoning ability were abstracted from students’ observable acts during history taking in the encounter. These were: taking control, recognizing and responding to relevant information, specifying symptoms, asking specific questions that point to pathophysiological thinking, placing questions in a logical order, checking agreement with patients, summarizing and body language. In addition, patients’ acts and the course, result and efficiency of the conversation were identified as indicators of clinical reasoning, whereas context, using self as a reference, and emotion/feelings were identified by the clinicians as variables in their assessment of clinical reasoning. Conclusions In observing and assessing clinical reasoning during history taking by medical students, general and specific phenomena to be used as indicators for this process could be identified. These phenomena can be traced back to theories on the development and the process of clinical reasoning.http://link.springer.com/article/10.1186/s12909-017-0983-3Clinical reasoningHistory takingAssessmentUndergraduate medical education |
| spellingShingle | Catharina M. Haring Bernadette M. Cools Petra J. M. van Gurp Jos W. M. van der Meer Cornelis T. Postma Observable phenomena that reveal medical students' clinical reasoning ability during expert assessment of their history taking: a qualitative study BMC Medical Education Clinical reasoning History taking Assessment Undergraduate medical education |
| title | Observable phenomena that reveal medical students' clinical reasoning ability during expert assessment of their history taking: a qualitative study |
| title_full | Observable phenomena that reveal medical students' clinical reasoning ability during expert assessment of their history taking: a qualitative study |
| title_fullStr | Observable phenomena that reveal medical students' clinical reasoning ability during expert assessment of their history taking: a qualitative study |
| title_full_unstemmed | Observable phenomena that reveal medical students' clinical reasoning ability during expert assessment of their history taking: a qualitative study |
| title_short | Observable phenomena that reveal medical students' clinical reasoning ability during expert assessment of their history taking: a qualitative study |
| title_sort | observable phenomena that reveal medical students clinical reasoning ability during expert assessment of their history taking a qualitative study |
| topic | Clinical reasoning History taking Assessment Undergraduate medical education |
| url | http://link.springer.com/article/10.1186/s12909-017-0983-3 |
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