Evidence map›Paper›PMID 33076879›Full record

ArticleBMC medical education2020

Assessing clinical reasoning in undergraduate medical students during history taking with an empirically derived scale for clinical reasoning indicators.

Sophie Fürstenberg, Tillmann Helm, Sarah Prediger, Martina Kadmon, Pascal O Berberat, Sigrid Harendza

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Article in BMC medical education, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

15 citing papers in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

6 authors.

Sophie FürstenbergDepartment of Internal Medicine, University Medical Center Hamburg-Eppendorf, III Medizinische Klinik, Martinistr. 52, D-20246, Hamburg, Germany.
Tillmann HelmDepartment of Internal Medicine, University Medical Center Hamburg-Eppendorf, III Medizinische Klinik, Martinistr. 52, D-20246, Hamburg, Germany.
Sarah PredigerDepartment of Internal Medicine, University Medical Center Hamburg-Eppendorf, III Medizinische Klinik, Martinistr. 52, D-20246, Hamburg, Germany.
Martina KadmonFaculty of Medicine, University of Augsburg, Deanery, Augsburg, Germany.
Pascal O BerberatTUM Medical Education Center, School of Medicine, Technical University of Munich, Munich, Germany.
Sigrid HarendzaDepartment of Internal Medicine, University Medical Center Hamburg-Eppendorf, III Medizinische Klinik, Martinistr. 52, D-20246, Hamburg, Germany. harendza@uke.de.

Funding

Bundesministerium für Bildung und Forschung 01PK1501A/B/C
6 · The paper itself

Abstract

backgroundThe clinical reasoning process, which requires biomedical knowledge, knowledge about problem-solving strategies, and knowledge about reasons for diagnostic procedures, is a key element of physicians' daily practice but difficult to assess. The aim of this study was to empirically develop a Clinical Reasoning Indicators-History Taking-Scale (CRI-HT-S) and to assess the clinical reasoning ability of advanced medical students during a simulation involving history taking.

methodsThe Clinical Reasoning Indictors-History Taking-Scale (CRI-HT-S) including a 5-point Likert scale for assessment was designed from clinical reasoning indicators identified in a qualitative study in 2017. To assess indicators of clinical reasoning ability, 65 advanced medical students (semester 10, n = 25 versus final year, n = 40) from three medical schools participated in a 360-degree competence assessment in the role of beginning residents during a simulated first workday in hospital. This assessment included a consultation hour with five simulated patients which was videotaped. Videos of 325 patient consultations were assessed using the CRI-HT-S. A factor analysis was conducted and the students' results were compared according to their advancement in undergraduate medical training.

resultsThe clinical reasoning indicators of the CRI-HT-S loaded on three factors relevant for clinical reasoning: 1) focusing questions, 2) creating context, and 3) securing information. Students reached significantly different scores (p < .001) for the three factors (factor 1: 4.07 ± .47, factor 2: 3.72 ± .43, factor 3: 2.79 ± .83). Students in semester 10 reached significantly lower scores for factor 3 than students in their final year (p < .05).

conclusionsThe newly developed CRI-HT-S worked well for quantitative assessment of clinical reasoning indicators during history taking. Its three-factored structure helped to explore different aspects of clinical reasoning. Whether the CRI-HT-S has the potential to be used as a scale in objective structured clinical examinations (OCSEs) or in workplace-based assessments of clinical reasoning has to be investigated in further studies with larger student cohorts.

Indexed as

Education, Medical, UndergraduateStudents, MedicalClinical CompetenceClinical ReasoningHumansMedical History TakingPhysical ExaminationAssessmentClinical reasoningCompetenceHistory takingMedical education

Identifiers

PMID33076879
PMCPMC7574202

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.