Teaching Clinical Reasoning Among Undergraduate Medical Students: a Crossover Randomised Trial

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Abstract Background: clinical reasoning is a mandatory competency in medical curriculum. Many techniques have been reported in order to teach it. The authors focused on 2 student-centered techniques, SNAPPS and collaborative critical reasoning learning (CCRL) technique, and compared their efficiency in order to improve the clinical reasoning competencies of third year medical education students.Methods: the authors performed a prospective randomised, controlled, non blinded crossover trial including year-3 undergraduate medical students. Judgement criteria consisted in the scores attributed to a structured summary performed by the students after each session. Besides, a satisfaction likert-scale questionnaire was fulfilled by the students. Statistical analysis was performed using SPSS software (version 20.0).Results: 72 students were included with a mean age of 21 years. The mean scores of CCRL reached 4.62 versus 4.99 for SNAPPS. No significant statistical difference was observed between the mean scores according to the method used. The analysis of the satisfaction questionnaire revealed that 75% of the students preferred the CCRL because of the collaborative work performed.Conclusion: this study highlights the need for varying techniques in order to improve critical reasoning skills of medical students. Besides, it pointed out the preference of students for collaborative techniques illustrating socio-constructivist theories of learning.

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