부산대학교 도서관

This article presents an overview of how to best guide medical students and residents learning clinical reasoning, discusses the considerations for effective teaching approaches, and provides suggestions for several effective and practical general teaching methods and special teaching techniques. Recent research on information-processing model suggests that clinicians organize knowledge in memory similar to the orderly modeling of a computer program. The more effective a clinician processes medical information, the more likely it would lead to efficient clinical reasoning and derive in correct diagnosis. Information-processing model allows medical education researchers to build on knowledge representation in memory, known as 'illness script', i.e., mental representations of the clinical manifestations and findings that can be observed with a given disease, which results in the enhancement of acquiring, storing and recalling knowledge in memory. It leads to the development and application of 'illness script' model as a general teaching approach in clinical reasoning. Current literature indicates that clinical reasoning is based on the dual process theory, integrating non-analytical and analytical models of thinking and decision making process. Learners are expected to develop reasoning abilities for recognizing disease pattern, generating initial hypotheses, and making differential diagnosis. Teachers should help students build their own 'illness script' library to improve clinical reasoning. The importance of 'deliberate practice' and 'self-regulated learning' toward the optimal development of reasoning skills and ability is emphasized and discussed. Specific teaching tools such as instinctive clinical teaching approach, the 'one-minute preceptor' model, and SNAPPS are introduced to promote 'think out loud' during teaching and discussion sessions. It makes reasoning process visible to learners to enhance reflective learning. The tactics for effective delivery of lectures are also discussed. The goal of this article is to provide clinical faculties teaching tools to guide students learning clinical reasoning effectively.