Course Design of Clinical Reasoning in General Practice for General Practice Master Students of Tongji University

Abstract

The construction of general practitioner (GP) workforce has tended to be mature over recent years, but the overall insufficient competencies of GPs is still one difficulty to be tackled for the construction of GP workforce. Clinical reasoning plays a central role in connecting various abilities in competency training of GPs in China, which is the key to improving the quality of general medical services. To cultivate the clinical reasoning of GPs, Tongji University offers a compulsory course named Clinical Reasoning in General Practice for general practice master students. The course is framed using the Miller's pyramid framework, includes three parts of core module (containing inquiry ability, physical examination, auxiliary examination and patient-doctor communication) , case module (covering undifferentiated illnesses, chronic disease management, coexistence of multiple diseases, psychosomatic diseases and health management) and practice module (including patient reception practice and medical record writing) , which fully reflect the basic characteristics of GPs' competencies. The course requires 32 credit hours, and is taught in multiple forms, including theory teaching, class discussion, problem-based learning and practical sessions. The effectiveness of course learning is assessed using the objective structured clinical examination, which is divided into four test stations: medical history collection, physical examination, patient-doctor communication and wring SOAP notes. Compared with relevant previous courses with separation between course design and actual community services, this course fully reflects the characteristics of general medicine, and helps students to enhance their competencies via improving the level of clinical reasoning.

Keywords

• general practitioners|clinical reasoning|post competency|master|teaching|curriculum design