Clinical Reasoning Skills Among Second-Phase Medical Students in West Bengal, India: An Exploratory Study.

Introduction Proper application of clinical reasoning skills is essential to reduce diagnostic and management errors. Explicit inclusion of training and assessment of clinical reasoning skills is the demand of time. The study intended to measure the clinical reasoning skills of second-phase undergraduate students in a medical college in West Bengal, India, and its distribution across several individual variables. Methods The clinical reasoning skills of 105 undergraduate medical students were assessed in a cross-sectional exploratory study using key feature questions (KFQs) with the partial credit scoring system. Six case vignettes aligned to the core competencies in the subject of pharmacology, pathology, and microbiology were designed and validated by the subject material experts for this purpose. The responses of the participants were collected through Google Forms (Google, Mountain View, CA) after obtaining written informed consent. The scores obtained in all KFQs were added and expressed in percentage of the maximum attainable score. Results The mean (±SD) clinical reasoning score of the participants was 42.5 (±12.6). Only 29.6% of respondents scored ≥ 50. Students with higher subjective economic status (p-value = 0.01) and perceived autonomy (p-value < 0.001) were more likely to have higher clinical reasoning scores. The marks obtained in previous summative examinations were significantly correlated with clinical reasoning scores. Conclusion Average score < 50.0 and inability to score ≥ 50.0 by more than two-thirds of the participants reflected the deficit in the clinical reasoning skills of second-phase MBBS students. The association of clinical reasoning skills with economic status, autonomy, and previous academic performances needs further exploration.