Medical Journal of The Islamic Republic of Iran (MJIRI)
Iran University of Medical Sciences
Thu, Nov 21, 2024
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Volume 34, Issue 1 (2-2020)
Med J Islam Repub Iran 2020 |
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Delavari S, Monajemi A, Baradaran H R, Myint P K, Yaghmae M, Soltani Arabshahi S K. How to develop clinical reasoning in medical students and interns based on illness script theory: An experimental study. Med J Islam Repub Iran 2020; 34 (1) :63-67
URL: http://mjiri.iums.ac.ir/article-1-5568-en.html
URL: http://mjiri.iums.ac.ir/article-1-5568-en.html
Somayeh Delavari 
, Alireza Monajemi , Hamid Reza Baradaran , Phyo Kyaw Myint , Minoo Yaghmae , Seyed Kamran Soltani Arabshahi
, Alireza Monajemi , Hamid Reza Baradaran , Phyo Kyaw Myint , Minoo Yaghmae , Seyed Kamran Soltani Arabshahi
Center for Educational Research in Medical Sciences (CERMS), Department of Medical Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran , soltarab@iums.ac.ir
Abstract: (2653 Views)
Background: Although theory explains the development of illness script, it does not provide answers how medical students develop scripts in their learning. To fill the knowledge gap of developing illness script in medical students and interns, this study aimed to investigate the impact of educational strategies inspired by theory in the development of illness scripts.
Methods: A total of 15 medical students and 12 interns participated in an educational intervention that included theory-driven strategies. To evaluate the impact of this intervention, clinical reasoning problem (CRP) and key features (KF) tests were used for before and after the intervention. In addition to descriptive statistics, the differences in participants’ pretest and posttest variables were tested using Wilcoxon. Significance level was set at p≤0.05 for all tests.
Results: Interns significantly recognized more KF in the posttest. However, no significant difference was found between the pretest and posttest scores in total diagnostic accuracy (5.41±1.16 vs 4.91±1.44; p=0.111) and total correct discriminating score (0.41±0.66 vs 1.41±2.06; p=0.146). Medical students produced less total key features in the posttest, indicating that they became less elaborate in their case processing. However, no significant difference was observed in common KF score (0.4 [0.25-0.78] vs 0.9 [0.6-1]; p=0.791) and discriminative key features score (0.33 [0.16-0.33] vs 0.22 [0.11-0.44]; p=0.972) in the posttest compared to the pretest.
Conclusion: This study showed that theory-driven educational strategies have an impact on illness script development specifically in interns. It is recommended that this intervention would be tested on those in higher levels of expertise (ie, residents).
Methods: A total of 15 medical students and 12 interns participated in an educational intervention that included theory-driven strategies. To evaluate the impact of this intervention, clinical reasoning problem (CRP) and key features (KF) tests were used for before and after the intervention. In addition to descriptive statistics, the differences in participants’ pretest and posttest variables were tested using Wilcoxon. Significance level was set at p≤0.05 for all tests.
Results: Interns significantly recognized more KF in the posttest. However, no significant difference was found between the pretest and posttest scores in total diagnostic accuracy (5.41±1.16 vs 4.91±1.44; p=0.111) and total correct discriminating score (0.41±0.66 vs 1.41±2.06; p=0.146). Medical students produced less total key features in the posttest, indicating that they became less elaborate in their case processing. However, no significant difference was observed in common KF score (0.4 [0.25-0.78] vs 0.9 [0.6-1]; p=0.791) and discriminative key features score (0.33 [0.16-0.33] vs 0.22 [0.11-0.44]; p=0.972) in the posttest compared to the pretest.
Conclusion: This study showed that theory-driven educational strategies have an impact on illness script development specifically in interns. It is recommended that this intervention would be tested on those in higher levels of expertise (ie, residents).
Keywords: Illness script, Clinical reasoning, Clinical decision-making, Medical education, Medical student, Education, Undergraduate
Type of Study: Original Research: Clinical Science |
Subject:
Clinical Reasoning
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