PDF(Pubmed)
Abstract：
BACKGROUND: Case-based clinical reasoning (CBCR) is the proposed method to improve clinical reasoning. This brief report aimed to evaluate CBCR effectiveness to improve clinical reasoning via an online course.
METHODS: This study is a brief report of a before-after quasi-experimental study to evaluate CBCR in medical students of Shahid Beheshti University of Medical Sciences.
METHODS: Ten online weekly 2-hour sessions of CBCR presentations were instructed to medical students. Each session started with an illness script, and then, the instructor posed the students\' five clinical questions in five steps according to the CBCR approach. The clinical reasoning ability of students was evaluated before and 2 weeks after the online courses using four types of standard clinical questions.
METHODS: A Wilcoxon signed-rank test was used to assess the difference between pretest and posttest examination scores.
RESULTS: This brief report revealed that twenty-one medical students participated in all ten sessions of the CBCR online course and were evaluated in pretest and posttest examinations. A significant improvement in the clinical reasoning total scores in the posttest examination compared with the pretest examination was observed (P = 0.001). In terms of specific types of clinical questions, the mean posttest scores for clinical reasoning problem (CRP) and key feature (KF) examinations were higher than the pretest scores (P = 0.001 and P = 0.005, respectively).
CONCLUSIONS: Applying the CBCR approach improved the total clinical reasoning score of medical students during the course. Further studies are needed to evaluate whether this improvement would persist in workplace settings or not.
METHODS: This study is a brief report of a before-after quasi-experimental study to evaluate CBCR in medical students of Shahid Beheshti University of Medical Sciences.
METHODS: Ten online weekly 2-hour sessions of CBCR presentations were instructed to medical students. Each session started with an illness script, and then, the instructor posed the students\' five clinical questions in five steps according to the CBCR approach. The clinical reasoning ability of students was evaluated before and 2 weeks after the online courses using four types of standard clinical questions.
METHODS: A Wilcoxon signed-rank test was used to assess the difference between pretest and posttest examination scores.
RESULTS: This brief report revealed that twenty-one medical students participated in all ten sessions of the CBCR online course and were evaluated in pretest and posttest examinations. A significant improvement in the clinical reasoning total scores in the posttest examination compared with the pretest examination was observed (P = 0.001). In terms of specific types of clinical questions, the mean posttest scores for clinical reasoning problem (CRP) and key feature (KF) examinations were higher than the pretest scores (P = 0.001 and P = 0.005, respectively).
CONCLUSIONS: Applying the CBCR approach improved the total clinical reasoning score of medical students during the course. Further studies are needed to evaluate whether this improvement would persist in workplace settings or not.
摘要：
背景：基于案例的临床推理（CBCR）是提出的改善临床推理的方法。这份简短的报告旨在通过在线课程评估CBCR的有效性，以改善临床推理。
方法：本研究是对ShahidBeheshti医科大学医学生进行CBCR评估的一项前后准实验研究的简要报告。
方法：指导医学生每周进行10次2小时CBCR演示。每次会议都以疾病脚本开始，然后,根据CBCR方法，教师分五个步骤向学生提出了五个临床问题。使用四种标准临床问题在在线课程之前和之后2周评估学生的临床推理能力。
方法：使用Wilcoxon符号秩检验来评估测试前和测试后考试成绩之间的差异。
结果：这份简短报告显示，有21名医学生参加了CBCR在线课程的所有十个课程，并在测试前和测试后的考试中进行了评估。与测试前检查相比，测试后检查的临床推理总分显着提高（P=0.001）。就特定类型的临床问题而言，临床推理问题(CRP)和关键特征(KF)检查的平均测前评分高于测前评分(分别为P=0.001和P=0.005).
结论：应用CBCR方法提高了医学生在课程中的临床推理总分。需要进一步的研究来评估这种改善是否会在工作场所环境中持续存在。
方法：本研究是对ShahidBeheshti医科大学医学生进行CBCR评估的一项前后准实验研究的简要报告。
方法：指导医学生每周进行10次2小时CBCR演示。每次会议都以疾病脚本开始，然后,根据CBCR方法，教师分五个步骤向学生提出了五个临床问题。使用四种标准临床问题在在线课程之前和之后2周评估学生的临床推理能力。
方法：使用Wilcoxon符号秩检验来评估测试前和测试后考试成绩之间的差异。
结果：这份简短报告显示，有21名医学生参加了CBCR在线课程的所有十个课程，并在测试前和测试后的考试中进行了评估。与测试前检查相比，测试后检查的临床推理总分显着提高（P=0.001）。就特定类型的临床问题而言，临床推理问题(CRP)和关键特征(KF)检查的平均测前评分高于测前评分(分别为P=0.001和P=0.005).
结论：应用CBCR方法提高了医学生在课程中的临床推理总分。需要进一步的研究来评估这种改善是否会在工作场所环境中持续存在。
