Factors associated with performance in clinical reasoning tests of neurological localization : a study in internal medicine residents

Background: Clinical Reasoning is the cognitive process of weighing clinical information together with past experience to evaluate diagnostic and management dilemmas. A variety of paper tests have been validated to assess clinical reasoning skills, but there has been a dearth of literature regarding...

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Main Author: Loh, Kieng Wee
Other Authors: Nigel Tan
Format: Final Year Project (FYP)
Language:English
Published: 2017
Subjects:
Online Access:http://hdl.handle.net/10356/72637
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author Loh, Kieng Wee
author2 Nigel Tan
author_facet Nigel Tan
Loh, Kieng Wee
author_sort Loh, Kieng Wee
collection NTU
description Background: Clinical Reasoning is the cognitive process of weighing clinical information together with past experience to evaluate diagnostic and management dilemmas. A variety of paper tests have been validated to assess clinical reasoning skills, but there has been a dearth of literature regarding factors influencing the development of these skills at the postgraduate level. We performed a retrospective study on Internal Medicine Residents to determine the sociodemographic and educational correlates of Clinical Reasoning in Neurological Localization. Methods: Subjects comprised of 162 Internal Medicine Residents on a three month attachment at the National Neuroscience Institute, Singapore, over a period of 2.5 years. Clinical Reasoning was assessed on the second month of their internship via two tests of Neurological Localization – Extended Matching Questions (EMQs) and Script Concordance Tests (SCTs). Data on Gender, Undergraduate Training Institution (UTI), Residency Programme and Amount of Clinical Experience were recorded, and their association with EMQ and SCT scores evaluated via univariate and multivariate analyses. Results: Univariate analysis indicated significant associations between Undergraduate Training Institution, Amount of Clinical Experience, EMQ and SCT Scores. Subsequent multivariate analyses suggested that Clinical Experience and UTI are positive predictors of EMQ Scores (adjusted R2 = 0.049, f2 = 0.052). Local Graduates also performed better than Overseas Graduates in the SCT (adjusted R2 = 0.101, f2 = 0.112), independent of other variables Conclusions: Development of Clinical Reasoning in Neurological Localization can be predicted via a two-factor model – Undergraduate Training Institution and Amount of Clinical Experience. Context specificity likely underlies the entire process.
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spelling ntu-10356/726372020-11-01T05:33:20Z Factors associated with performance in clinical reasoning tests of neurological localization : a study in internal medicine residents Loh, Kieng Wee Nigel Tan Lee Kong Chian School of Medicine (LKCMedicine) DRNTU::Science::Medicine Background: Clinical Reasoning is the cognitive process of weighing clinical information together with past experience to evaluate diagnostic and management dilemmas. A variety of paper tests have been validated to assess clinical reasoning skills, but there has been a dearth of literature regarding factors influencing the development of these skills at the postgraduate level. We performed a retrospective study on Internal Medicine Residents to determine the sociodemographic and educational correlates of Clinical Reasoning in Neurological Localization. Methods: Subjects comprised of 162 Internal Medicine Residents on a three month attachment at the National Neuroscience Institute, Singapore, over a period of 2.5 years. Clinical Reasoning was assessed on the second month of their internship via two tests of Neurological Localization – Extended Matching Questions (EMQs) and Script Concordance Tests (SCTs). Data on Gender, Undergraduate Training Institution (UTI), Residency Programme and Amount of Clinical Experience were recorded, and their association with EMQ and SCT scores evaluated via univariate and multivariate analyses. Results: Univariate analysis indicated significant associations between Undergraduate Training Institution, Amount of Clinical Experience, EMQ and SCT Scores. Subsequent multivariate analyses suggested that Clinical Experience and UTI are positive predictors of EMQ Scores (adjusted R2 = 0.049, f2 = 0.052). Local Graduates also performed better than Overseas Graduates in the SCT (adjusted R2 = 0.101, f2 = 0.112), independent of other variables Conclusions: Development of Clinical Reasoning in Neurological Localization can be predicted via a two-factor model – Undergraduate Training Institution and Amount of Clinical Experience. Context specificity likely underlies the entire process. Bachelor of Medicine and Bachelor of Surgery 2017-08-31T05:00:23Z 2017-08-31T05:00:23Z 2017 Final Year Project (FYP) http://hdl.handle.net/10356/72637 en 12 p. application/pdf
spellingShingle DRNTU::Science::Medicine
Loh, Kieng Wee
Factors associated with performance in clinical reasoning tests of neurological localization : a study in internal medicine residents
title Factors associated with performance in clinical reasoning tests of neurological localization : a study in internal medicine residents
title_full Factors associated with performance in clinical reasoning tests of neurological localization : a study in internal medicine residents
title_fullStr Factors associated with performance in clinical reasoning tests of neurological localization : a study in internal medicine residents
title_full_unstemmed Factors associated with performance in clinical reasoning tests of neurological localization : a study in internal medicine residents
title_short Factors associated with performance in clinical reasoning tests of neurological localization : a study in internal medicine residents
title_sort factors associated with performance in clinical reasoning tests of neurological localization a study in internal medicine residents
topic DRNTU::Science::Medicine
url http://hdl.handle.net/10356/72637
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