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Tytuł:
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A developmental assessment of clinical reasoning in preclinical medical education.
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Autorzy:
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Min Simpkins AA; a Department of Emergency Medicine and the Assistant Dean for Faculty Development in the College of Medicine - Tucson , University of Arizona , Tucson , AZ , USA.
Koch B; b Arizona Center for Rural Health , University of Arizona College of Public Health , Tucson , AZ , USA.
Spear-Ellinwood K; c Department of Obstetrics and Gynecology and the Director of Faculty Instructional Development at the College of Medicine - Tucson , University of Arizona , Tucson , AZ , USA.
St John P; d Department of Cellular and Molecular Medicine at the College of Medicine-Tucson , University of Arizona , Tucson , AZ , USA.
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Źródło:
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Medical education online [Med Educ Online] 2019 Dec; Vol. 24 (1), pp. 1591257.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: 2016- : Philadelphia, PA : Taylor & Francis
Original Publication: [E. Lansing, MI] : Medical Education Online, [1996-
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MeSH Terms:
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Problem Solving*
Clinical Decision-Making/*methods
Education, Medical/*methods
Educational Measurement/*methods
Clinical Competence ; Curriculum ; Humans ; Learning
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References:
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Teach Learn Med. 2000 Fall;12(4):189-95. (PMID: 11273368)
Acad Emerg Med. 2011 Jun;18(6):627-34. (PMID: 21676061)
J Grad Med Educ. 2015 Sep;7(3):334-7. (PMID: 26457135)
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Contributed Indexing:
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Keywords: Clinical reasoning; assessment; medical education
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Entry Date(s):
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Date Created: 20190403 Date Completed: 20190708 Latest Revision: 20200225
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Update Code:
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20240104
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PubMed Central ID:
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PMC6450466
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DOI:
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10.1080/10872981.2019.1591257
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PMID:
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30935299
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Background: Clinical reasoning is an essential skill to be learned during medical education. A developmental framework for the assessment and measurement of this skill has not yet been described in the literature.
Objective: The authors describe the creation and pilot implementation of a rubric designed to assess the development of clinical reasoning skills in pre-clinical medical education.
Design: The multi-disciplinary course team used Backwards Design to develop course goals, objectives, and assessment for a new Clinical Reasoning Course. The team focused on behaviors that students were expected to demonstrate, identifying each as a 'desired result' element and aligning these with three levels of performance: emerging, acquiring, and mastering.
Results: The first draft of the rubric was reviewed and piloted by faculty using sample student entries; this provided feedback on ease of use and appropriateness. After the first semester, the course team evaluated whether the rubric distinguished between different levels of student performance in each competency. A systematic approach based on descriptive analysis of mid- and end of semester assessments of student performance revealed that from mid- to end-of-semester, over half the students received higher competency scores at semester end.
Conclusion: The assessment rubric allowed students in the early stages of clinical reasoning development to understand their trajectory and provided faculty a framework from which to give meaningful feedback. The multi-disciplinary background of the course team supported a systematic and robust course and assessment design process. The authors strongly encourage other colleges to support the use of collaborative and multi-disciplinary course teams.
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