School of Medicine

Clinical reasoning is the complex cognitive analysis employed by physicians during the medical decision making process. This is first introduced in the problem-based learning (PBL) course in the preclinical medical school curriculum with the PBL facilitator playing a critical role in meeting these educational goals. However, factors, such as the instructor's clinical experience and teaching style, will have an impact the group's engagement in the clinical reasoning process. Thus, the clinical reasoning tool was developed to address this variability, with the goal of strengthening small group engagement in clinical reasoning during PBL. The clinical reasoning tool (CRT) is an online educational application, which provides a framework for the process of developing and analyzing the differential diagnosis for a clinical case. It was assigned as a self-directed learning assignment to one student per small group for selected second-year PBL cases during one academic quarter. There was a >70% CRT implementation rate across the seven selected cases with a total of 86 CRT look-ups produced. Overall, students felt the tool provided a useful framework for developing and analyzing a clinical case, however 68% were dissatisfied with the tool, citing concerns about suboptimal implementation and tool functionality, and only 18% felt it offered educational value. In contrast, 57% of faculty facilitators found the CRT to be a useful educational resource, though in need of a modified implementation approach. The CRT has the potential to serve as a valuable educational tool. However, its role within the medical school curriculum must be optimized. Consequently, there are several areas for improvement and innovation in the CRT, including tool design, curricular implementation, and educational outcomes evaluation. Overall, this project allowed educators to explore new teaching modalities at the level of undergraduate medical education.