Can preclinical students improve their clinical reasoning skills only by taking case-based online testlets? A randomized controlled study

ABSTRACT

The prominent method to teach clinical reasoning in preclinical years is case-based discussions. It necessitates hours of sessions. A randomised-controlled study has been conducted to determine whether preclinical students can develop illness scripts only by taking online formative testlets. A pre-test-post-test randomised-controlled design has been utilised. The intervention group (N = 20) answered general surgery questions for 18 days, while the control group (N = 19) received questions regarding urinary tract infections. These testlets were comprised of ContExtended Questions, which is a web-based tool to teach clinical reasoning. The performance was assessed by using Key-Feature Questions. While post-test scores   were significantly higher than pre-test scores   in the intervention group (p < 0.001), there was no statistically significant difference between the pre-test   and post-test   scores in the control group (p = 0.30). Taking formative case-based multiple-choice testlets without any additional teaching could assist preclinical students to learn clinical reasoning.

KEYWORDS:

• Clinical reasoning
• preclinical
• online test
• case-based
• illness scripts
• online teaching

Acknowledgments

We would like to thank to Gazi University Faculty of Medicine Year-3 students who have participated in the study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary Material

Supplemental data for this article can be accessed here

Additional information

Funding

This study was conducted to contribute to the PhD Thesis of Yavuz Selim KIYAK, ‘Developing A New Method and Electronic System for Assessment of Clinical Reasoning Skills in Medical Education’. Gazi University Projects of Scientific Investigation (BAP) supported the study (code:Gazi Üniversitesi 01/2020-24).

Notes on contributors

Yavuz Selim Kıyak

Yavuz Selim Kıyak is a medical doctor and has a PhD degree in Medical Education. His research interests include clinical reasoning, formative assessment, and distributed ledger technologies such as Holochain. He dedicated himself spreading the knowledge regarding Medical Education using social media.

Işıl İrem Budakoğlu

Işıl İrem Budakoğlu is a medical doctor, specialist of Public Health, professor of medical education, and chair of the Department of Medical Education and Informatics. She teaches communication skills, leadership, and critical thinking in medicine at all levels. Her research interests include medical education.

Dilara Bakan Kalaycıoğlu

Dilara Bakan Kalaycıoğlu is an associate professor of educational measurement and evaluation programme at the Gazi University, Turkey. Previously, she was developing assessment instruments for the Assessment, Selection and Placement Center. Her researches mainly focus on educational data mining, large-scale assessments and measurement invariance.

Serdar Kula

Serdar Kula is one of the founders of the Department of Medical Informatics at Gazi University. He organised the first virtual synchronous international symposium in 2011. In 2018, he established Digital Medical Education Applications Board. He is also the chair of health informatics at Gazi University Informatics Institute.

Özlem Coşkun

Özlem Coşkun is a medical doctor and an associate professor of Medical Education in the Department of Medical Education and Informatics, Gazi University Faculty of Medicine. She teaches evidence-based medicine, critical thinking and faculty development. Her research interests include e-learning, teaching and learning in medical education.