Remediation Of Clinical Reasoning In UME: A Systematic Review
Objective: Systematic review of existing literature
on methods for remediating clinical reasoning deficits in undergraduate medical
education.
Data Sources: Comprehensive database
search was conducted in March 2022 of PubMed, Embase, Medline (via OVID),
Scopus, Web of Science, and ERIC using a combination of keywords and controlled
vocabulary to search for \"clinical reasoning\", \"undergraduate
education\", and \"remediation\" conceptual groups. Search was
restricted to English language without date constraints. Initial search
returned 2426 articles with 7 studies selected for final analysis.
Methods of Study Selection: Primary studies that specifically addressed
clinical reasoning remediation in medical students and included at least a
framework or outcome data.
Tabulation, Integration and Results: Final articles were reviewed for
extraction of data such as remediation modality, faculty training, timeframe,
post-remediation outcomes and satisfaction. Thematic analysis was conducted for
qualitative data. Of the 7 analyzed articles, most addressed general
remediation of clinical skills of which clinical reasoning was a subset. Only 2
articles specifically focused on remediation of clinical reasoning and only 1
of these, an observational study, included a thorough description of the
program as well as quantitative outcome data.
Conclusion:
Although there exists extensive literature on teaching and assessing clinical
reasoning, remediation is not well represented. Guides from remediation experts
provide useful recommendations on developing remediation programs. However,
this review demonstrates the relative dearth of primary studies on clinical
reasoning remediation in UME suggesting an area of further research on the
design and outcomes of structured programs to enable adaption for variable
settings with reliable outcomes.
