Collection of clinical reasoning OERs

Topic outline

• General
  

  General

  This course is a meta course, which presents a group-reviewed collection of open educational resources (OERs) that have been assigned to the learning goals/objectives from D2.1.

  
  

  Last update: May 3, 2021
  
• Icon legend
  

  Icon legend

  app                             list                              checklist                         tool

  article                        cases                          simulation                      database

  video                          project                       curriculum                     workshop/lecture
• (1) Theories of clinical reasoning
  

  (1) Theories of clinical reasoning

  • Basics of Clinical Reasoning URL

    An introduction into clinical reasoning including a curated list highlighting the top academic articles, multimedia, and resources by the Society to Improve Diagnosis in Medicine (SIDM).

  • Bridging the Gap Between the Classroom and the Clerkship: A Clinical Reasoning Curriculum for Third-Year Medical Students URL

    This article describes longitudinal curricula for clinical reasoning with the following learning objectives: "Identify the key concepts and terminology pertaining to clinical reasoning, including metacognition, dual process theory, illness scripts, and cognitive biases; Apply clinical reasoning skills to patient care, including data organization, development of summary statements, problem representation, and prioritized differential diagnosis; Recognize common cognitive biases encountered in clinical practice through the practice of metacognition."
    

  • Diagnosing and Remediating Clinical Reasoning Difficulties: A Faculty Development Workshop URL

    This article describes a faculty workshop to help teachers understand the cognitive theory behind clinical reasoning, accurately define clinical reasoning terminology, identify cognitive biases, recognize clinical reasoning difficulties among students and improve clinical reasoning skills by discussing errors.
    

  • Introductory Clinical Reasoning Curriculum URL

    This article describes a theoretic introduction into clinical reasoning in the form of a curriculum for first and second-year medical students, as well as two basic patient cases.
    

  • A Guide to Developing Clinical Reasoning Skills in Neurology: A Focus on Medical Students URL

    This article describes a course, which incorporates clinically relevant clerkship content for a process-oriented approach to learning with a focus on neurology.
    

• (2) Gathering, interpreting, and synthesizing patient information
  

  (2) Gathering, interpreting, and synthesizing patient information

  • CASUS URL

    Virtual patient database, which lets students, doctors and healthcare professionals continually aquire and practice their clinical reasoning skills. Also, an important resource to evaluate CR progress and uncover standard mistakes. The resource includes cases that have a specially designed clinical reasoning concept mapping tool.
    

  • The Simulated Virology Clinic: A Standardized Patient Exercise for Preclinical Medical Students Supporting Basic and Clinical Science Integration URL

    A simulated clinical activity, in which medical students are confronted with viral patients and have to apply their knowledge of diagnostic problem-solving and clinical reasoning.
    

  • The GI Simulated Clinic: A Clinical Reasoning Exercise Supporting Medical Students' Basic and Clinical Science Integration URL

    This article describes simulation training to support cognitive integration among first-year medical students.
    

  • Insomnia Telemedicine OSCE (TeleOSCE): A Simulated Standardized Patient Video-Visit Case for Clerkship Students URL

    This article focuses on telemedicine and how to assess patients remotely and aims to implement a standardized telemedicine OSCE in (U.S.) medical schools.
    

  • Common Variable Immunodeficiency: A Standardized Patient Case for Second-Year Medical Students URL

    This article is focused on taking an accurate and comprehensive history of a patient. The results of this study also show the discrepancies in clinical reasoning skills between high and low-performing students
    

  • Clinical Reasoning in the Primary Care Setting: Two Scenario-Based Simulations for Residents and Attendings URL

    This article describes simulations that help students gather patient information, develop treatment plans that support their clinical reasoning hypothesis, and reflect on their reasoning, decision-making and strategies.
    

  • Abdominal Anatomy Tutorial Using a Medical Imaging Platform URL

    This article describes a tutorial, which helps students read and interpret medical images (focus on abdominal anatomy) and apply this knowledge/skill to clinical scenarios.
    

  • Self-Directed Rater Training for Pediatric History and Physical Exam Evaluation (P-HAPEE) Rubric, a Validated Written H&P Assessment Tool URL

    This article describes an assessment tool for (pediatrics) students, which evaluates their written patient history and physical examination skills.
    

  • Clinical Reasoning Workshop: Cervical Spine and Shoulder Disorders URL

    This article describes how residents can be taught to switch between the automatic and reflective modes of dual processing and improve their decision-making skills.
    

  • Interpretation of Data Workshop in the Pediatric Preclerkship Educational Exercises (PRECEDE) Curriculum URL

    This article describes a curriculum for pre-clerkship medical students and teaches them to develop basic skills and knowledge in pediatrics.
    

  • Clinical Decision-Making for Older Patients With Multiple Chronic Conditions: A Case-Based Exercise for Medical Students URL

    This resource describes a session for second-year medical students, in which students practice using a framework for clinical decision-making for patients with multimorbidity.
    

  • Case-Based Discussion: Hypertension URL

    This article describes a case for first-year medical students and introduces them to physiology, pathophysiology and clinical reasoning.
    

  • Structured Oral Examinations in Internal Medicine URL

    This article is one of a nine-part series of cases, which can be used to test and assess students' clinical reasoning skills using a standardized format. All nine cases can be accessed here: Case A, Case B, Case C, Case D, Case E, Case F, Case G, Case H, Case I.
    

  • Cardinal Manifestations and Presentation of Disease—Making the Rounds on Standardized Patients With Alterations in Cardiac, Respiratory, Gastrointestinal, and Genitourinary Function URL

    This article describes an organized approach to having medical students present certain diseases especially in the cardiac, respiratory, gastrointestinal, and urinary and urogenital systems.
    

• (3) Generating differential diagnoses including defining and discriminating features
  

  (3) Generating differential diagnoses including defining and discriminating features

  • Teaching Medicine URL

    Platform that currently offers 10 VP cases, which are structured into introduction, history, physical exam, and investigation. Students must find up to 5 different diagnoses that they can rate in probability depending on the information they are given. The investigation must be done by the students themselves; they choose the investigations and must analyze the results.

    
    

  • Clinical Reasoning in the Ward Setting: A Rapid Response Scenario for Residents and Attendings URL

    This article presents various educational resources and approaches to practice and assess clinical reasoning skills on a wide range of experience levels.
    

  • Medical Student Bridge Program Case: Mary Beth Chrispy URL

    This article describes a prematriculation program designed to introduce students to medical school teaching and also to expose students to basic clinical reasoning skills by having them work on a case prior to starting medical school.
    

  • Diagnostic Reasoning Assessment Toolkit: Guided Reflection and Standardized Cases for At-Risk Final-Year Medical Students URL

    This article describes various short cases, which can be used to identify specific learner deficiencies in clinical reasoning by focusing on individual student work and by standardizing faculty evaluation.
    

  • Differential Diagnosis: Approaches and Pitfalls - A Pediatric Case-Based Session for 3rd-Year Medical Students URL

    This article describes a combined lecture/case-based approach, in which students are presented with basic clinical reasoning concepts and specific heuristics, followed by simulated pediatric cases.
    

• (4) Developing a treatment/management plan
  

  (4) Developing a treatment/management plan

  • ADA URL

    Ada is a mobile app, which connects medical knowledge with intelligent technology to help patients actively manage their health, enter their symptoms and receive a comprehensive treatment plan and allows medical professionals to deliver effective care.
    

  • SPRINT Through Tasks: A Novel Curriculum for Improving Resident Task Management in the Emergency Department URL

    This article describes a task-management tool and a curriculum to facilitate emergency room residents' multitasking skills and thus, improve patient care in the ER.
    

  • Chasing Fevers: An Interactive Exercise for Pediatrics Residents on Triaging and Assessing Inpatients With Fever URL

    This article describes an interactive discussion and case-based approach, which focuses on making clinical decisions concerning febrile pediatric patients.
    

  • Hypovolemic Shock in a Child: A Pediatric Simulation Case URL

    This article describes a simulation case, which allows students to demonstrate clinical reasoning skills, procedural skills, and management skills regarding hypovolemic shock, as well as being able to communicate with a child's parents.
    

  • Four Web-Based Interactive Endocrine Case Studies for Use in Undergraduate Medical Education URL

    This article describes four case-based activities that teach students to link basic science with clinical application and self-evaluate their knowledge.
    

  • Medication Optimization and Patient Education in Heart Failure: A Standardized Patient Case for Clerkship Students URL

    This article describes a patient case, which will help students optimize their medication therapy skills as well as how to communicate this and the process of self-monitoring to patients. It also provides an interprofessional aspect, in that it describes how to work together and communicate with other healthcare providers concerning a patient's medication regimen.
    

  • Interactive Team-Based Approach to Multiple Clinical Scenarios: A Third-Year Medical Student Exercise URL

    This article describes a role-play simulation, in which third-year medical students are put in the position of an attending physician who encounters multiple clinical scenarios and has to supervise medical students, address urgent issues and field patient phone calls.
    

  • Emergency Medicine Pre-Code Scenario: Theophylline Overdose URL

    This article describes a patient case simulation focusing on a theophylline overdose and requires the student to make a diagnosis and use knowledge skills to treat the underlying condition and all the complications.
    

• (5) Aspects of patient participation in clinical reasoning
  

  (5) Aspects of patient participation in clinical reasoning

  • Patient's Toolkit URL

    The patient toolkit is a resource that was created by patients to gather all the important information regarding their symptoms prior to consulting their physician and thus, allowing doctors to make faster and more reliable diagnoses.
    

  • Understanding Experiences of Chronic Illness from the Patient Perspective URL

    This article describes a course in which students learn to understand the patient's experience of illness, the clinician's approach to chronic illnesses and identify methods to navigate the healthcare system for chronically ill patients.
    

  • CASUS URL

    Virtual patient database, which lets students, doctors and healthcare professionals continually aquire and practice their clinical reasoning skills. Also, an important resource to evaluate CR progress and uncover standard mistakes. The resource includes cases that have a specially designed clinical reasoning concept mapping tool.
    

  • Shared Decision-Making (SDM) Toolkit: Train-the-Trainer Tools for Teaching SDM in the Classroom and Clinic URL

    This article describes a train-the-trainer toolkit for providing theoretical input on shared decision-making (SDM). It includes a useful pocket guide on SDM and is intended for residents and fellows as trainers.

  • Advance Care Planning and Shared Decision-Making: An Interprofessional Role-Playing Workshop for Medical and Nursing Students URL

    This article describes theories and role-play scenarios on how to lead advance care planning discussions (DNRs). It includes one video on the theoretical approach and one video of an actual conversation with patients, as well as four intensive care scenarios.
    

  • Four-Station Group Observed Structured Clinical Encounter for Formative Assessment of Communication Skills for Internal Medicine Clerks URL

    This article describes various role-play scenarios that require difficult doctor-patient interactions, such as treatment plans, delivering bad news, etc.
    

  • When Doctor Means Teacher: An Interactive Workshop on Patient-Centered Education URL

    This article describes a workshop on theoretical education as well as role-play scenarios on reaching diagnoses and administering medication for patients with hypertension, diabetes and depression. The emphasis lies on finding simple and understandable explanations for these common diagnoses.
    

• (6) Collaborative aspects of clinical reasoning
  

  (6) Collaborative aspects of clinical reasoning

  • Complexities of Clinical Genetics Consultation: An Interprofessional Clinical Skills Workshop URL

    This article describes the complexities of collaboration and interaction between physicians (mainly pediatricians) and genetics counselors and how to simulate exposure.
    

  • A Simulated Mass Casualty Incident Triage Exercise: SimWars URL

    This article describes a simulation scenario, in which students are divided into two groups and have to manage a triage situation. The excercise promotes collaboration, coordination, teamwork and communication skills in a critical situation.
    

  • Dehydration: A Multidisciplinary Case-Based Discussion for First-Year Medical Students URL

    This article describes a case-based example that requires students to apply various aspects of their scientific knowledge on a first-year level: biology, biochemistry, physiology and clinical reasoning.
    

  • Team-Based Learning Is Effective in Teaching Appropriate Utilization of Hemostasis Laboratory Tests Using Storyline Case-Authoring Software URL

    This article discusses a team-based learning activity, which requires students to find differential diagnoses, develop a treatment plan and outline their clinical reasoning approach.
    

  • Team-Based Simulation for Medical Student Handoff Education URL

    This article describes simulation exercises to practice handoffs and communication skills, as well as working together with physicians from other specialities.
    

  • Fever and Seizure in a Young Infant: A Simulation Case URL

    This article describes a simulation case that requires making critical decisions as a team and how to employ effective communication skills within the team and also with the patient's parents.
    

• (7) Interprofessional aspects of clinical reasoning
  

  (7) Interprofessional aspects of clinical reasoning

  • Shoulder Dystocia and Neonatal Resuscitation: An Integrated Obstetrics and Neonatology Simulation Case for Medical Students URL

    This article describes a training module, which teaches students to consolidate clinical knowledge and practice decision-making skills, teamwork and communication. It is a case-based simulation followed by a debriefing that illustrates the interprofessional aspects of pediatrics and obstetrics in a clinical reasoning process.
    

  • Teaching Patient Handoffs to Medical Students in Obstetrics and Gynecology: Simulation Curriculum and Assessment Tool URL

    This article describes a simulation to practice handoffs and communication with other healthcare providers and also presents an assessment tool to evaluate students' communication skills.
    

  • Rash in Breast-Feeding Mother: Standardized Patient Case for Clerkship Students URL

    This article illustrates one standardized patient case, which highlights the importance of interprofessional aspects of clinical reasoning in that it requires students to work together with nurses and pharmacologists in deciding and reasoning on dispensing and administering medication.
    

  • A Large-Scale Interprofessional Simulation Experience, Module 2: What Happens in Vegas Does Not Stay in Vegas URL

    This article describes a patient case that involves three healthcare professions that need to work together in order to provide the best possible patient care.
    

  • A Large Scale Interprofessional Simulation Experience for Medical, Nursing, and Pharmacy Students URL

    This article describes a patient case that involves three healthcare professions that need to work together in order to provide the best possible patient care.
    

  • Working Together: Interactive Interprofessional Learning in the Classroom URL

    This article describes an approach to a multidisciplinary interactive case study that positively influences students attitudes regarding teamwork, professional identity, mutual respect and self-assessed clinical reasoning.
    

• (8) (Interprofessional) Collaboration and exchange (TTT)
  

  (8) (Interprofessional) Collaboration and exchange (TTT)

  • Situation, Background, Assessment and Recommendation (SBAR) URL

    SBAR is a widely used communication tool that helps nurses and doctors work together and find the best treatment for patients by providing only important and concise information.
    

  • Coffee Talks: An Innovative Approach to Teaching Clinical Reasoning and Information Mastery to Medical Students URL

    This article describes an approach to teaching medical students how to present their cases and findings and reinterpret these within a group of peers and educators.
    

• (9) Ethical aspects
  

  (9) Ethical aspects

  • Project Implicit: Bias Tests URL

    This project provides free tests on testing personal biases concerning health, race, gender, etc. and can help make students and physicians aware of their personal hidden biases and work on avoiding these when treating patients.
    

  • Cognitive Debiasing Strategies: A Faculty Development Workshop for Clinical Teachers in Emergency Medicine URL

    This article scrutinizes a faculty development workshop, which teaches educators about common biases and debiasing strategies in order to improve teaching diagnostic reasoning to students.
    

  • Case Studies In Family Medicine URL

    This article describes eight interactive case studies that aim to foster students' clinical reasoning skills and also raise awareness and sensitivity in a cultural context and improve their feel for psychosocial factors.
    

  • The Developing Physician — Becoming a Professional URL

    This article discusses the importance of professionalism in the medical field, with regard to physicians in particular and how to teach professionalism to medical students.
    

  • Professionalism and Ethics: A Standardized Patient Observed Standardized Clinical Examination to Assess ACGME Pediatric Professionalism Milestones URL

    Pediatric cases with a strong emphasis on ethical reasoning. All but one case involve a discussion with a parent about treatment options facing different ethical challenges. The last one is a discussion with a teenager about drug testing. It describes the first real curriculum on ethical aspects of clinical reasoning.
    

    
    

  • Four Medical Ethics Team-Based Learning Modules URL

    This article describes ethics-related cases, whose objectives are to spark discussions about topics such as organ donation, blood transfusion and duty to warn and to teach students to differentiate between what they believe to be best for the patient from a medical/legal perspective and what is their duty as the patient’s doctor and trustee.
    

• (10) Self-reflection on clinical reasoning performance and strategies for future improvement
  

  (10) Self-reflection on clinical reasoning performance and strategies for future improvement

  • Improving Decision Making URL

    A collection of cognitive strategies and diagnostic checklists to reflect on and improve clinical reasoning.
    

  • Clinical Reasoning Workshop: Lumbosacral Spine and Hip Disorders URL

    This article describes a workshop that uses deductive (making the correct diagnosis) and inductive (identifying a history key feature and a physical exam key feature) modes of clinical reasoning and allows learners to use these interchangeably and self-reflect on these strategies.
    

  • Developing a Unified List of Physicians’ Reasoning Tasks During Clinical Encounters URL

    This article describes a list of reasoning tasks that were documented during clinical encounters and how these tasks helped physicians make their decisions. It is intended to provide insight for discussing, teaching and researching clinical reasoning.
    

  • Clinical Reasoning: Survey of Teaching Methods, Integration, and Assessment in Entry-Level Physical Therapist Academic Education URL

    This article describes a survey about how clinical reasoning is currently being taught and how it is understood in entry-level physical therapist education. It concludes that clinical reasoning is taught differently at each school and that a standard does not exist, but urgently needs to be developed.
    

  • Systematic Clinical Reasoning in Physical Therapy (SCRIPT): Tool for the Purposeful Practice of Clinical Reasoning in Orthopedic Manual Physical Therapy URL

    This case illustrates how the Systematic Clinical Reasoning in Physical Therapy (SCRIPT) tool can guide the clinical reasoning process and prompt a physical therapist to search the literature to answer a clinical question and facilitate formal mentorship sessions in postprofessional physical therapist training programs.
    

  • Integrated clinical experience with concurrent problem-based learning is associated with improved clinical reasoning among physical therapy students in the United States URL

    This article describes how ICE with concurrent PBL results in improved self-reported clinical reasoning and concludes that monitoring the impact of curricular design on clinical reasoning may improve educators’ ability to enhance cognitive and psychomotor skills, which underscores the importance of increasing the explicit use of theoretical frameworks and teaching techniques for coping with uncertainty as a way of enhancing entry-level training.
    

  • Effects of live and video simulation on clinical reasoning performance and reflection URL

    This article describes a study in which physicians' clinical reasoning skills were compared in a live scenario versus a video simulation. It conlcudes that the live condition participants focused more attention on aspects of the clinical reasoning process and demonstrated higher level cognitive processing than the video group.
    

• (11) Errors in the clinical reasoning process and strategies to avoid them
  

  (11) Errors in the clinical reasoning process and strategies to avoid them

  • How We Make Decisions URL

    Articles on clinical errors and how decisions are made and the consequences thereof.
    

  • Clinician Checklists URL

    Process and content checklists that provide clinicians with strategies and steps in making a diagnosis and the most common errors.
    

  • Diagnostic Errors URL

    A compilation of literature that discusses diagnostic errors, their consequences and ways to avoid them.
    

  • Teaching Cognitive Bias in a Hurry: Single-Session Workshop Approach for Psychiatry Residents and Students URL