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Jackson JM, Skelton JA, Peters TR. Medical Students' Clinical Reasoning During a Simulated Viral Pandemic: Evidence of Cognitive Integration and Insights on Novices' Approach to Diagnostic Reasoning. Med Sci Educ. 2020;1-8doi: 10.1007/s40670-020-00946-9.
Jackson, J. M., Skelton, J. A., & Peters, T. R. (2020). Medical Students' Clinical Reasoning During a Simulated Viral Pandemic: Evidence of Cognitive Integration and Insights on Novices' Approach to Diagnostic Reasoning. Medical science educator, 1-8. https://doi.org/10.1007/s40670-020-00946-9
Jackson, Jennifer M, et al. "Medical Students' Clinical Reasoning During a Simulated Viral Pandemic: Evidence of Cognitive Integration and Insights on Novices' Approach to Diagnostic Reasoning." Medical science educator vol. (2020): 1-8. doi: https://doi.org/10.1007/s40670-020-00946-9
Jackson JM, Skelton JA, Peters TR. Medical Students' Clinical Reasoning During a Simulated Viral Pandemic: Evidence of Cognitive Integration and Insights on Novices' Approach to Diagnostic Reasoning. Med Sci Educ. 2020 May 06;1-8. doi: 10.1007/s40670-020-00946-9. Epub 2020 May 06. PMID: 32382451; PMCID: PMC7202796.
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Med Sci Educ. 2020 May 06;1-8. doi: 10.1007/s40670-020-00946-9. Epub 2020 May 06.

Medical Students' Clinical Reasoning During a Simulated Viral Pandemic: Evidence of Cognitive Integration and Insights on Novices' Approach to Diagnostic Reasoning.

Medical science educator

Jennifer M Jackson, Joseph A Skelton, Timothy R Peters

Affiliations

  1. 1Department of Pediatrics, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 USA.
  2. 2Department of Pediatrics; Department of Epidemiology & Prevention, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 USA.

PMID: 32382451 PMCID: PMC7202796 DOI: 10.1007/s40670-020-00946-9

Abstract

INTRODUCTION: Cognitive integration from multiple disciplines is essential to clinical problem-solving. Because it is not directly observable, demonstrating evidence of learners' cognitive integration remains a challenge. In addition, little is known about preclinical medical students' approach to diagnostic reasoning despite widespread implementation of clinical reasoning curricula for these early learners. The objectives of this study were to characterize how first-year medical students integrated knowledge to problem-solve during a simulated viral pandemic and to characterize students' diagnostic reasoning approach to this clinical scenario.

MATERIALS AND METHODS: Student teams analyzed clinical data to formulate hypotheses for the pandemic's source and submitted reports justifying their hypotheses and treatment recommendations. A content analysis on students' reports identified codes and themes characterizing the learning content integrated and students' approaches to diagnostic reasoning tasks.

RESULTS: Sixteen problem-solving codes were identified, demonstrating integration of new and previously encountered content from multiple disciplines. A compare-contrast analytical approach was the most commonly employed diagnostic reasoning approach (100%), with a smaller subset of teams also using a causal approach (20%).

DISCUSSION: Content analysis of preclinical students' diagnostic justification tasks provided insights into their approach to diagnostic reasoning, which was most consistent with the search-inference framework rather than a causal approach, likely due to limited pathophysiological knowledge at that point in training.

CONCLUSIONS: Evidence of cognitive integration can be made explicit through learners' narrative justification of diagnostic reasoning tasks. Preclinical students' diagnostic reasoning development has implications for curricular design and implementation for this learner group.

© International Association of Medical Science Educators 2020.

Keywords: Cognitive integration; Diagnostic reasoning; Epidemiology; Simulation; Virology

Conflict of interest statement

Conflict of InterestThe authors declare that they have no conflicts of interest.

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