USING AN EXPERIENTIAL LEARNING MODEL TO TEACH CLINICAL REASONING THEORY AND COGNITIVE BIAS: AN EVALUATION OF A FIRST-YEAR MEDICAL STUDENT CURRICULUM
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Keywords
Curriculum, Script Theory, Dual Process Theory, Clinical Reasoning Examination, Cognitive Bias.
Abstract
Background: The majority of medical students who start clerkships don't fully grasp the fundamentals of clinical reasoning. It is unclear if first-year medical students benefit from learning about cognitive biases and theories of clinical reasoning.
Objective: The purpose of this study was to assess the benefits of providing first-year medical students with specific instruction in cognitive bias and clinical reasoning theory.
Methodology: We used the experiential education method to teach clinical thinking to first-year medical learners at Women Medical College. Additionally, we discussed cognitive prejudices, script theory, and dual process theory. The investigation was conducted in 2021, namely from March to December. Due to the COVID-19 pandemic, lessons were shifted to a format for distance learning in May 2021. The program included a number of written tests on clinical reasoning along with support for discussions in smaller groups. Via written self-evaluations participants were compelled to consider their observations, draw conclusions about their clinical reasoning skills, and plan for potential future clinical reasoning encounters. We evaluated the curriculum's value using a combination of approaches, looking at staff evaluations, student self-evaluation inquiries, and a confidential end-of-curriculum inquiry that gathered feedback from learners.
Results: Out of the 317 exams that 105 participants took in total, 253 (79%) had a comprehensive problem representation, and 198 (62%) had a problem representation that was deemed concise. In their clinical reasoning, the learners most frequently mentioned anchoring bias, availability bias, and premature closure as cognitive biases. Students saw four main themes as important consequences of the CREs: Synthesis of medical knowledge;(2) improved capacity for making differential diagnoses;(3) growth in clinical reasoning self-efficacy; and (4) increased consciousness of one's own cognitive biases.
Conclusion: We discovered that first-year medical students benefit greatly from explicit instruction of ‘clinical reasoning theory and cognitive biases through an experiential learning’ paradigm. This allows them to gain important ‘knowledge, skills, and self-efficacy associated with clinical reasoning’.
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Dr Malik Faisal Iftekhar
Assistant Professor and Head of Department, Department of Cardiology, MTI - Lady Reading Hospital, Peshawar Pakistan
Dr Uzma Siddique
Lecturer, Department of Health Professions Education and Research (DHPER), Peshawar Medical College, Peshawar Pakistan
Dr Afreenish Malik
Lecturer, Department of Medical Medical Education, Khyber Medical University, Peshawar Pakistan
Dr Saiqa Saleem
Assistant Professor IHPER, Khyber Medical University, Peshawar Pakistan
Dr Muneeba Ghafoor
Lecturer, Department of Health Professions Education and Research, Muhammad College of Medicine, Peshawar Pakistan
Dr Zara Jameel
MHPE, Khyber Medical University, Peshawar Pakistan