Exploration of the application of case-based clinical reasoning in medical diagnostic education_West China Medical Journal

Authors：

WANG Tingli ¹ , QIU Hongyu ¹ ,  ZUO Chuan ²

1. Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Division of Diagnostics, West China Hospital / West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

ZUO Chuan, Email: 43013233@qq.com

Keywords：

Case-based clinical reasoning; diagnostics; clinical thinking

DOI：

10.7507/1002-0179.202411107

Video：

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As a crucial component of clinical medicine, the main task of diagnosis is to cultivate students’ ability to master systematic clinical thinking, disease diagnosis process, comprehensive analysis methods, and the ability to solve clinical problems. Introducing case-based clinical reasoning as a novel and advanced teaching method in the diagnosis course, in line with the comprehensive ability teaching objectives of the course, can provide students with a platform to apply learned knowledge in practical cases, enhance the fun and practicality of learning, improve students’ clinical thinking ability and practical skills, enable students to make quick and accurate judgments when facing complex cases, and ultimately enhance their ability to analyze and solve problems comprehensively. This article combines the experience of applying case-based clinical reasoning to undergraduate diagnosis at West China School of Medicine of Sichuan University, and explores the prospects of applying this teaching method in medical diagnostics.

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12.	Srinivasan M, Wilkes M, Stevenson F, et al. Comparing problem-based learning with case-based learning: effects of a major curricular shift at two institutions. Acad Med, 2007, 82(1): 74-82.
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14.	Durning S, Artino AR Jr, Pangaro L, et al. Context and clinical reasoning: understanding the perspective of the expert’s voice. Med Educ, 2011, 45(9): 927-938.
15.	Eva KW, Hatala RM, Leblanc VR, et al. Teaching from the clinical reasoning literature: combined reasoning strategies help novice diagnosticians overcome misleading information. Med Educ, 2007, 41(12): 1152-1158.
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19.	Alavi-Moghaddam M, Zeinaddini-Meymand A, Ahmadi S, et al. Teaching clinical reasoning to medical students: a brief report of case-based clinical reasoning approach. J Educ Health Promot, 2024, 13: 42.
20.	Keemink Y, Custers EJFM, van Dijk S, et al. Illness script development in pre-clinical education through case-based clinical reasoning training. Int J Med Educ, 2018, 9: 35-41.
21.	Harden RM. Essential skills for a medical teacher: an introduction to teaching and learning in medicine. New York: Elsevier Health Sciences, 2020.

1. Ten Cate TJ, Schadé E. Workshops clinical decision-making. One year experience with small group case-based clinical reasoning education//Gezond Onderwijs 2-proceedings of the second national conference on medical education. Dutch: Universitair Publikatiebureau KUN, 1993: 215-222.
2. Ten Cate O. Training case-based clinical reasoning in small groups. Ned Tijdschr Geneeskd, 1994, 138: 1238-1243.
3. Mandin H, Harasym P, Eagle C, et al. Developing a “clinical presentation” curriculum at the University of Calgary. Acad Med, 1995, 70(3): 186-193.
4. Mandin H, Jones A, Woloschuk W, et al. Helping students learn to think like experts when solving clinical problems. Acad Med, 1997, 72(3): 173-179.
5. Barrows HS, Tamblyn RM. Problem-based learning: an approach to medical education. Berlin: Springer Publishing Company, 1980.
6. Albanese MA, Mitchell S. Problem-based learning: a review of literature on its outcomes and implementation issues. Acad Med, 1993, 68(1): 52-81.
7. Hmelo-Silver CE. Problem-based learning: what and how do students learn?. Educ Psychol Rev, 2004, 16: 235-266.
8. Savery J. Essential readings in problem-based learning: exploring and extending the legacy of Howard S. Barrows. West Lafayette, Purdue Univ. Press, 2015: 5-15.
9. Flanagan OL, Cummings KM. Standardized patients in medical education: a review of the literature. Cureus, 2023, 15(7): e42027.
10. Mistry D, Brock CA, Lindsey T. The present and future of virtual reality in medical education: a narrative review. Cureus, 2023, 15(12): e51124.
11. Thistlethwaite JE, Davies D, Ekeocha S, et al. The effectiveness of case-based learning in health professional education. A BEME systematic review: BEME guide No. 23. Med Teach, 2012, 34(6): e421-e444.
12. Srinivasan M, Wilkes M, Stevenson F, et al. Comparing problem-based learning with case-based learning: effects of a major curricular shift at two institutions. Acad Med, 2007, 82(1): 74-82.
13. Durning SJ, Artino AR. Situativity theory: a perspective on how participants and the environment can interact: AMEE guide no. 52. Med Teach, 2011, 33(3): 188-199.
14. Durning S, Artino AR Jr, Pangaro L, et al. Context and clinical reasoning: understanding the perspective of the expert’s voice. Med Educ, 2011, 45(9): 927-938.
15. Eva KW, Hatala RM, Leblanc VR, et al. Teaching from the clinical reasoning literature: combined reasoning strategies help novice diagnosticians overcome misleading information. Med Educ, 2007, 41(12): 1152-1158.
16. Zijdenbos IL, de Haan MC, Valk GD, et al. A student-led course in clinical reasoning in the core curriculum. Int J Med Educ, 2010, 1: 42-46.
17. Zijdenbos I, Fick T, ten Cate O. How we offer all medical students training in basic teaching skills. Med Teach, 2011, 33(1): 24-26.
18. ten Cate O, Custers EJFM, Durning SJ. Principles and practice of case-based clinical reasoning education: a method for preclinical students. Cham: Springer, 2018.
19. Alavi-Moghaddam M, Zeinaddini-Meymand A, Ahmadi S, et al. Teaching clinical reasoning to medical students: a brief report of case-based clinical reasoning approach. J Educ Health Promot, 2024, 13: 42.
20. Keemink Y, Custers EJFM, van Dijk S, et al. Illness script development in pre-clinical education through case-based clinical reasoning training. Int J Med Educ, 2018, 9: 35-41.
21. Harden RM. Essential skills for a medical teacher: an introduction to teaching and learning in medicine. New York: Elsevier Health Sciences, 2020.

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