Project Objectives

To develop, implement and evaluate a teaching module to improve medical students’ clinical reasoning skills in fourth year undergraduate medical students.

Description of process and deliverables

We developed a 3-hour workshop aimed at developing skills in problem representation and creating appropriate illness scripts for diagnosis. The workshop consisted of integrated small group teaching using a web-based set of clinical reasoning problems, individualized feedback, and demonstration of tutors’ reasoning aloud. The web-based program comprised of a set of 20 clinical reasoning problems (CRP) for teaching, combined with a scoring system for assessment based on previously validated paper-based CRP. Teachers’ and students’ manuals were also developed.

Evaluation of outcomes

The effectiveness of the intervention was assessed using the Diagnostic Thinking Inventory (DTI) and the measurement of individual students’ performance in CRP between 53 students randomly assigned to either a Family Medicine (intervention) or Psychiatric (control) clerkship. The post-intervention overall DTI scores between groups were similar but the total scores on the CRP assessment were 14% (95%CI: 8% to 21%) higher in workshop participants than controls.

Dissemination of results & deliverables

Results were presented at a Faculty of Medicine curriculum retreat and it is currently undergoing peer-review for journal publication.