A Preclinical Course to Develop Clinical Reasoning Skills of First-year Medical Students

Abstract

Background and Objectives: Clinical reasoning is developed sometime during medical school training. When and how this knowledge is attained is less clear. This study looks at clinical reasoning development after initiation of a rural experiential course for first-year medical students at the University of Minnesota Medical School, Duluth (regional) Campus. Methods: The Rural Medical Scholars Program course (RMSP) was developed to create a longitudinal rural family medicine experience for first and second-year students at the University of Minnesota Medical School Duluth. Sixty-three first year medical students participated in this required course and their clinical reasoning levels were measured using the Diagnostic Thinking Inventory (DTI). The DTI was given to the medical students after one year of participation in the RMSP course. A previous cohort before the RMSP course was developed was used as a control. A literature search was used for comparison to other schools that measured the DTI in their students. Results: Student diagnostic thinking performance as measured by the DTI after one year of the Rural Medical Scholars Program course significantly increased when compared to a previous cohort of first-year students who did not take the RMSP course. When compared to previously published DTI data, students after one year of RMSP had clinical reasoning levels of second through fourth-year students from other schools. Conclusions: The addition of a rural experiential course with family medicine preceptors significantly increased clinical reasoning levels of first-year medical students. Financial support: None Conflicts of Interests: No conflicts to report

Keywords

• clinical reasoning
• family medicine
• experimental learning