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Teaching Teachers how to Teach

Developing Teachers of Clinical Reasoning. Dhaliwal G. Clinical Teacher 2013; 10:313-317.


Reviewed by Gary Beck

What was the purpose?
To provide clinical teachers training to better instruct learners on how to develop clinical reasoning skills.

How was the innovation conducted?
This article describes a 2-hour workshop developed to instruct clinical teachers how to teach and remediate clinical reasoning. The workshop presents a 4-step model of clinical reasoning, which the author states is not intended to be a complete theoretical model but a simplified process that is readily evaluated by instructors. The 4 steps include data collection, problem representation, illness script contents, and script selection. Analogies are used to teach these steps, such as likening illness scripts to files on a desktop containing information about individual diseases. After the presentation of the model, the remainder of the time is used to analyze case studies where participants are asked to make an assessment of each of the four steps of the model and propose an educational plan for the deficient step.

What were the outcomes?
This workshop has been delivered 19 times over 6 years. Faculty and community-based preceptors (n=98) have taken the workshop; a mixed methods approach was used to evaluate the workshop. Post-workshop evaluation data indicated the session was valuable. Comments corroborated positive numeric ratings but also provided suggestions for improving the training. The author acknowledged that data has not yet been collected to determine the impact on teaching or learning these workshops have had.

What are the implications of these findings?
This is a quick and easy workshop that could be delivered at any institution. The table with their agenda provides direction about what to present during the training. The table has each section broken down by amount of time to present and time for the case discussions. Clerkship directors could conduct this for new residents and faculty to teach and remediate clinical reasoning skills in medical students.

 

Editor’s note: That the clinical teachers feel better equipped to teach, assess, and remediate clinical reasoning following this workshop is fantastic. What is missing in this study is whether or not the students were better at clinical reasoning if they worked with a graduate of this workshop – hopefully the authors will conduct and share such a study (SLB).

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