Advances in Medical Education and Practice (Nov 2024)
Enhancing Clinical Reasoning Education: Implementing Case Conferences with Semantic Qualifiers and the Dual-Process Theory
Abstract
Yoshinori Tokushima,1,2 Risa Hirata,1 Shun Yamashita,1,3 Kiyoshi Shikino,4,5 Taro Shimizu,6 Masaki Tago1 1Department of General Medicine, Saga University Hospital, Saga, Japan; 2Saga Medical Career Support Center, Saga University Hospital, Saga, Japan; 3Education and Research Center for Community Medicine, Faculty of Medicine, Saga University, Saga, Japan; 4Department of General Medicine, Chiba University Hospital, Chiba, Japan; 5Department of Community-Oriented Medical Education, Chiba University Graduate School of Medicine, Chiba, Japan; 6Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Tochigi, JapanCorrespondence: Masaki Tago, Department of General Medicine, Saga University Hospital, 5-1-1 Nabeshima, Saga, 849-8501, Japan, Tel +81 952 34 3238, Fax +81 952 34 2029, Email [email protected]: Clinical reasoning skills are crucial for physicians. In clinical reasoning conferences using real cases, medical students, residents, and senior residents can follow experts’ clinical reasoning processes. However, supervisors may struggle to clearly articulate their clinical reasoning process. It is necessary to demonstrate this process concretely and systematically for educational purposes. This study introduces the method of clinical reasoning case conferences using semantic qualifiers and the dual-process theory designed for outpatient cases to improve clinical reasoning education methods for beginners. In these conferences, participants assume the roles of a moderator, learner, presenter, and commentator. The presenter sets the first semantic qualifier from the chief complaint and pre-examination information, presents the present illness history, and then sets the second semantic qualifier. After the learners propose a snap diagnosis, the presenter provides additional information, and the learners develop a comprehensive differential diagnosis. Finally, the presenter shares the examination results, and the group discusses the results, determines the final diagnosis, and decides the future diagnostic strategy. This method helps expert physicians articulate their clinical reasoning process, aiding in the education of learners at all levels and enhancing supervisors’ metacognition of their medical practice.Keywords: clinical reasoning, semantic qualifier, dual process theory, case conference, education
