Teaching clinical reasoning through hypothetico-deduction is (slightly) better than self-explanation in tutorial groups: An experimental study.
Perspect Med Educ
; 7(2): 93-99, 2018 04.
Article
en En
| MEDLINE
| ID: mdl-29484551
ABSTRACT
BACKGROUND:
Self-explanation while individually diagnosing clinical cases has proved to be an effective instructional approach for teaching clinical reasoning. The present study compared the effects on diagnostic performance of self-explanation in small groups with the more commonly used hypothetico-deductive approach.METHODS:
Second-year students from a six-year medical school in Saudi Arabia (39 males; 49 females) worked in small groups on seven clinical vignettes (four criterion cases representing cardiovascular diseases and three 'fillers', i.e. cases of other unrelated diagnoses). The students followed different approaches to work on each case depending on the experimental condition to which they had been randomly assigned. Under the self-explanation condition, students provided a diagnosis and a suitable pathophysiological explanation for the clinical findings whereas in the hypothetico-deduction condition students hypothesized about plausible diagnoses for signs and symptoms that were presented sequentially. One week later, all students diagnosed eight vignettes, four of which represented cardiovascular diseases. A mean diagnostic accuracy score (range 0-1) was computed for the criterion cases. One-way ANOVA with experimental condition as between-subjects factor was performed on the mean diagnostic accuracy scores.RESULTS:
Students in the hypothetico-deduction condition outperformed those in the self-explanation condition (meanâ¯= 0.22, standard deviationâ¯= 0.14, meanâ¯= 0.17; standard deviationâ¯= 0.12; F(1, 88)â¯= 4.90, pâ¯= 0.03, partial η2â¯= 0.06, respectively).CONCLUSIONS:
Students in the hypothetico-deduction condition performed slightly better on a follow-up test involving similar cases, possibly because they were allowed to formulate more than one hypothesis per case during the learning phase.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Estudiantes de Medicina
/
Pensamiento
/
Competencia Clínica
Límite:
Adult
/
Female
/
Humans
/
Male
País/Región como asunto:
Asia
Idioma:
En
Revista:
Perspect Med Educ
Año:
2018
Tipo del documento:
Article
País de afiliación:
Arabia Saudita