Clinical Reasoning Skills

Role of the Instructor

Instructors should strive to facilitate learning, encourage spontaneity, and engage in mutual inquiry with students, in the manner of a coach. This participation of the instructor as a coach increases the value of the educational experience. The role of the instructor should not be primarily information transfer.

An instructor must be comfortable in a group setting as the members of the group engage in critical thinking. The group may challenge the instructor's information and beliefs. The instructor should keep the group setting informal, comfortable, flexible, and nonthreatening to enhance adult learning.

An instructor must evaluate students according to their level of training and with the flexibility inherent in the clinical reasoning process. Students must be evaluated in multiple settings with multiple contexts for clinical cases over time. Students may arrive at a correct diagnosis without explaining the reasoning process or supporting knowledge. Students may be able to elaborate upon causal reasoning with factual data, but not arrive at a diagnosis. Hence, clinical reasoning is a journey and not just a destination. That journey can take multiple paths to the same place. The experiences along the journey are different for each student. Student progress can vary over time.

References:

Eva KW. What every teacher needs to know about clinical reasoning. Med Educ. 2005;39(1):98-106.

Kassirer JP. Teaching clinical reasoning: case-based and coached. Acad Med. 2010; 85:1118-1124.