Implementing Clinical Case Discussions to Enhance Clinical Reasoning Skills: A Pilot Study in an Italian Medical School

Author:

Colonnello Valentina1,Zodl Aurelia2,Agnoletti Davide34,Lischeid Kilian2,Cimbalnik Lena2,Weidenbusch Marc5,Fischer Martin R.5ORCID,De Ponti Fabrizio6ORCID,Rausch Christian7ORCID

Affiliation:

1. Psychology Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy

2. Faculty of Medicine, Ludwig Maximilian University of Munich, 80336 Munich, Germany

3. Hypertension and Cardiovascular Risk Research Group, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy

4. Cardiovascular Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy

5. Institute for Medical Education, University Hospital of LMU Munich, 80336 Munich, Germany

6. Pharmacology Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy

7. Department of Medicine III, LMU University Hospital, 81377 Munich, Germany

Abstract

Background: Clinical reasoning (CR) is fundamental in medical education. However, the Italian curriculum has not incorporated a structured CR format yet. Therefore, we introduced the Clinical Case Discussions (CCD), to medical students attending the University of Bologna as a tool for developing CR abilities. CCDs are a case-based peer-teaching format, simulating the diagnostic process using published patient cases. Methods: Students of all clinical years of the University of Bologna Medical School were invited to voluntarily participate in a two-day CCD training program. They completed pre- and post-training questionnaires assessing their expectations before and impressions after the training and comparing learning outcomes to their usual classes. Results: Twenty-one students participated in this pilot program. Before the training, more than half of the participants expressed either interest or a strong interest in all proposed learning objectives. Afterward, 84.6% of the students stated that the training much exceeded (63.5%) or exceeded (23.1%) their expectations considering its utility for their future medical activities. A total of 92.3% strongly agreed (84.6%) or agreed (7.7%) to have improved their CR. Conclusions: Although this pilot program had some intrinsic limitations, the students’ positive feedback on this CCD format (combining the benefits of case-based learning and peer teaching) encourages further research on its potential role in the Italian curriculum.

Publisher

MDPI AG

Reference33 articles.

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2. Clinical Reasoning: Defining It, Teaching It, Assessing It, Studying It;Gruppen;West. J. Emerg. Med.,2017

3. Clinical Reasoning Curricula in Preclinical Undergraduate Medical Education: A Scoping Review;Hawks;Acad. Med.,2023

4. The General Medical Council (2024, February 23). Outcomes for Graduates. Available online: https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/outcomes-for-graduates/.

5. Frank, J.R., Snell, L., and Sherbino, J. (2015). Canmeds 2015 Physician Competency Framework, Royal College of Physicians and Surgeons of Canada.

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