Minding the gap: towards a shared clinical reasoning lexicon across the pre-clerkship/clerkship transition

Teaching and learning of clinical reasoning are core principles of medical education. However, little guidance exists for faculty leaders to navigate curricular transitions between pre-clerkship and clerkship curricular phases. This study compares how educational leaders in these two phases understa...

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Main Authors: Robin K. Ovitsh, Shanu Gupta, Anita Kusnoor, Jennifer M. Jackson, Danielle Roussel, Christopher J. Mooney, Roshini Pinto-Powell, Joel L. Appel, Rahul Mhaskar, Jonathan Gold
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Medical Education Online
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Online Access:https://www.tandfonline.com/doi/10.1080/10872981.2024.2307715
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author Robin K. Ovitsh
Shanu Gupta
Anita Kusnoor
Jennifer M. Jackson
Danielle Roussel
Christopher J. Mooney
Roshini Pinto-Powell
Joel L. Appel
Rahul Mhaskar
Jonathan Gold
author_facet Robin K. Ovitsh
Shanu Gupta
Anita Kusnoor
Jennifer M. Jackson
Danielle Roussel
Christopher J. Mooney
Roshini Pinto-Powell
Joel L. Appel
Rahul Mhaskar
Jonathan Gold
author_sort Robin K. Ovitsh
collection DOAJ
description Teaching and learning of clinical reasoning are core principles of medical education. However, little guidance exists for faculty leaders to navigate curricular transitions between pre-clerkship and clerkship curricular phases. This study compares how educational leaders in these two phases understand clinical reasoning instruction. Previously reported cross-sectional surveys of pre-clerkship clinical skills course directors, and clerkship leaders were compared. Comparisons focused on perceived importance of a number of core clinical reasoning concepts, barriers to clinical reasoning instruction, level of familiarity across the undergraduate medical curriculum, and inclusion of clinical reasoning instruction in each area of the curriculum. Analyses were performed using the Mann Whitney U test. Both sets of leaders rated lack of curricular time as the largest barrier to teaching clinical reasoning. Clerkship leaders also noted a lack of faculty with skills to teach clinical reasoning concepts as a significant barrier (p < 0.02), while pre-clerkship leaders were more likely to perceive that these concepts were too advanced for their students (p < 0.001). Pre-clerkship leaders reported a higher level of familiarity with the clerkship curriculum than clerkship leaders reported of the pre-clerkship curriculum (p < 0.001). As faculty transition students from the pre-clerkship to the clerkship phase, a shared understanding of what is taught and when, accompanied by successful faculty development, may aid the development of longitudinal, milestone-based clinical reasoning instruction.
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spelling doaj-art-159623c87f424d6cbf7fc22ccf58b7f82025-08-20T02:49:06ZengTaylor & Francis GroupMedical Education Online1087-29812024-12-0129110.1080/10872981.2024.2307715Minding the gap: towards a shared clinical reasoning lexicon across the pre-clerkship/clerkship transitionRobin K. Ovitsh0Shanu Gupta1Anita Kusnoor2Jennifer M. Jackson3Danielle Roussel4Christopher J. Mooney5Roshini Pinto-Powell6Joel L. Appel7Rahul Mhaskar8Jonathan Gold9Department of Pediatrics, Downstate Health Sciences University College of Medicine, Brooklyn, NY, USADepartment of Internal Medicine, University of South Florida, Tampa, FL, USADepartment of Medicine, Baylor College of Medicine, Houston, TX, USADepartment of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC, USADepartment of Anesthesiology, University of Utah School of Medicine, Salt Lake City, UT, USADepartment of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USADepartment of Medicine and Medical Education, Geisel School of Medicine at Dartmouth, Hanover, NH, USADepartment of Internal Medicine, Wayne State University School of Medicine, Detroit, MI, USADepartment of Internal Medicine, University of South Florida College of Medicine, Tampa, FL, USADepartment of Pediatrics and Human Development, Michigan State University College of Human Medicine, East Lansing, MI, USATeaching and learning of clinical reasoning are core principles of medical education. However, little guidance exists for faculty leaders to navigate curricular transitions between pre-clerkship and clerkship curricular phases. This study compares how educational leaders in these two phases understand clinical reasoning instruction. Previously reported cross-sectional surveys of pre-clerkship clinical skills course directors, and clerkship leaders were compared. Comparisons focused on perceived importance of a number of core clinical reasoning concepts, barriers to clinical reasoning instruction, level of familiarity across the undergraduate medical curriculum, and inclusion of clinical reasoning instruction in each area of the curriculum. Analyses were performed using the Mann Whitney U test. Both sets of leaders rated lack of curricular time as the largest barrier to teaching clinical reasoning. Clerkship leaders also noted a lack of faculty with skills to teach clinical reasoning concepts as a significant barrier (p < 0.02), while pre-clerkship leaders were more likely to perceive that these concepts were too advanced for their students (p < 0.001). Pre-clerkship leaders reported a higher level of familiarity with the clerkship curriculum than clerkship leaders reported of the pre-clerkship curriculum (p < 0.001). As faculty transition students from the pre-clerkship to the clerkship phase, a shared understanding of what is taught and when, accompanied by successful faculty development, may aid the development of longitudinal, milestone-based clinical reasoning instruction.https://www.tandfonline.com/doi/10.1080/10872981.2024.2307715Clinical reasoningUMEpreclerkshipclerkshipclinical skillstransition
spellingShingle Robin K. Ovitsh
Shanu Gupta
Anita Kusnoor
Jennifer M. Jackson
Danielle Roussel
Christopher J. Mooney
Roshini Pinto-Powell
Joel L. Appel
Rahul Mhaskar
Jonathan Gold
Minding the gap: towards a shared clinical reasoning lexicon across the pre-clerkship/clerkship transition
Medical Education Online
Clinical reasoning
UME
preclerkship
clerkship
clinical skills
transition
title Minding the gap: towards a shared clinical reasoning lexicon across the pre-clerkship/clerkship transition
title_full Minding the gap: towards a shared clinical reasoning lexicon across the pre-clerkship/clerkship transition
title_fullStr Minding the gap: towards a shared clinical reasoning lexicon across the pre-clerkship/clerkship transition
title_full_unstemmed Minding the gap: towards a shared clinical reasoning lexicon across the pre-clerkship/clerkship transition
title_short Minding the gap: towards a shared clinical reasoning lexicon across the pre-clerkship/clerkship transition
title_sort minding the gap towards a shared clinical reasoning lexicon across the pre clerkship clerkship transition
topic Clinical reasoning
UME
preclerkship
clerkship
clinical skills
transition
url https://www.tandfonline.com/doi/10.1080/10872981.2024.2307715
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