Effects of reflection and immediate feedback to improve clinical reasoning of medical students in the assessment of dermatologic conditions: a randomised controlled trial

Abstract Background There are few studies that directly compared different interventions to improve medical students’ clinical reasoning for dermatologic conditions. Objective To investigate the effectiveness of adding practice with reflection and immediate feedback on traditional dermatology electi...

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Main Authors: Sungjun Choi, Sohee Oh, Dong Hun Lee, Hyun-Sun Yoon
Format: Article
Language:English
Published: BMC 2020-05-01
Series:BMC Medical Education
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12909-020-02063-y
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author Sungjun Choi
Sohee Oh
Dong Hun Lee
Hyun-Sun Yoon
author_facet Sungjun Choi
Sohee Oh
Dong Hun Lee
Hyun-Sun Yoon
author_sort Sungjun Choi
collection DOAJ
description Abstract Background There are few studies that directly compared different interventions to improve medical students’ clinical reasoning for dermatologic conditions. Objective To investigate the effectiveness of adding practice with reflection and immediate feedback on traditional dermatology electives in improving medical students’ ability in evaluating skin lesions. Methods The participants were fourth-year medical students of Seoul National University College of Medicine, Korea, who were enrolled to take a 2-week dermatology elective course (n = 87). Students were assigned to one of the three educational interventions: 2-h training involving 10 written clinical cases (experimental); 1-h lecture and 1-h outpatient clinic (lecture); and 2-h outpatient clinic (no intervention). Before and at the end of rotation, diagnostic accuracy was estimated using 20 written clinical cases with photographs (10 novel cases presented in diagnostic training [training set], 10 cases with diagnoses not included in training [control set]). Results There was a significant interaction effect of intervention×set×time. A post hoc analysis indicated that the students in the experimental group outperformed students in the other two groups only in the training set of the final tests; after completing the 2-week rotation, for the training set, the mean score was higher in the experimental group (7.5 ± 1.3) than in the lecture (5.7 ± 1.6) and no intervention (5.6 ± 1.3) groups, producing an effect size of 1.2 standard deviation (SD) and 1.5 SD, respectively. Conclusion Practicing written clinical cases with reflection and feedback is superior to a lecture-based approach and yields additional benefits to a dermatology elective, thereby enhancing medical students’ ability to accurately diagnose skin lesions. Trial registration ClinicalTrials.gov , NCT03472001 . Registered 21 March 2018.
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spelling doaj.art-e41f83677a7f42acaa0a01bab742b5922022-12-22T00:00:55ZengBMCBMC Medical Education1472-69202020-05-012011910.1186/s12909-020-02063-yEffects of reflection and immediate feedback to improve clinical reasoning of medical students in the assessment of dermatologic conditions: a randomised controlled trialSungjun Choi0Sohee Oh1Dong Hun Lee2Hyun-Sun Yoon3Department of Dermatology, Seoul National University HospitalDepartment of Biostatistics, SMG-SNU Boramae Medical CenterDepartment of Dermatology, Seoul National University College of MedicineDepartment of Dermatology, SMG-SNU Boramae Medical CenterAbstract Background There are few studies that directly compared different interventions to improve medical students’ clinical reasoning for dermatologic conditions. Objective To investigate the effectiveness of adding practice with reflection and immediate feedback on traditional dermatology electives in improving medical students’ ability in evaluating skin lesions. Methods The participants were fourth-year medical students of Seoul National University College of Medicine, Korea, who were enrolled to take a 2-week dermatology elective course (n = 87). Students were assigned to one of the three educational interventions: 2-h training involving 10 written clinical cases (experimental); 1-h lecture and 1-h outpatient clinic (lecture); and 2-h outpatient clinic (no intervention). Before and at the end of rotation, diagnostic accuracy was estimated using 20 written clinical cases with photographs (10 novel cases presented in diagnostic training [training set], 10 cases with diagnoses not included in training [control set]). Results There was a significant interaction effect of intervention×set×time. A post hoc analysis indicated that the students in the experimental group outperformed students in the other two groups only in the training set of the final tests; after completing the 2-week rotation, for the training set, the mean score was higher in the experimental group (7.5 ± 1.3) than in the lecture (5.7 ± 1.6) and no intervention (5.6 ± 1.3) groups, producing an effect size of 1.2 standard deviation (SD) and 1.5 SD, respectively. Conclusion Practicing written clinical cases with reflection and feedback is superior to a lecture-based approach and yields additional benefits to a dermatology elective, thereby enhancing medical students’ ability to accurately diagnose skin lesions. Trial registration ClinicalTrials.gov , NCT03472001 . Registered 21 March 2018.http://link.springer.com/article/10.1186/s12909-020-02063-yClinical reasoningMedication educationDermatology electiveReflectionFeedback
spellingShingle Sungjun Choi
Sohee Oh
Dong Hun Lee
Hyun-Sun Yoon
Effects of reflection and immediate feedback to improve clinical reasoning of medical students in the assessment of dermatologic conditions: a randomised controlled trial
BMC Medical Education
Clinical reasoning
Medication education
Dermatology elective
Reflection
Feedback
title Effects of reflection and immediate feedback to improve clinical reasoning of medical students in the assessment of dermatologic conditions: a randomised controlled trial
title_full Effects of reflection and immediate feedback to improve clinical reasoning of medical students in the assessment of dermatologic conditions: a randomised controlled trial
title_fullStr Effects of reflection and immediate feedback to improve clinical reasoning of medical students in the assessment of dermatologic conditions: a randomised controlled trial
title_full_unstemmed Effects of reflection and immediate feedback to improve clinical reasoning of medical students in the assessment of dermatologic conditions: a randomised controlled trial
title_short Effects of reflection and immediate feedback to improve clinical reasoning of medical students in the assessment of dermatologic conditions: a randomised controlled trial
title_sort effects of reflection and immediate feedback to improve clinical reasoning of medical students in the assessment of dermatologic conditions a randomised controlled trial
topic Clinical reasoning
Medication education
Dermatology elective
Reflection
Feedback
url http://link.springer.com/article/10.1186/s12909-020-02063-y
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