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Interprofessional clinical reasoning education

  • Thomas Eriksen ORCID logo EMAIL logo and Ismaïl Gögenur
Published/Copyright: July 5, 2024
Diagnosis
From the journal Diagnosis Volume 11 Issue 4

Abstract

Clinical reasoning is considered one of the most important competencies but is not included in most healthcare curricula. The number and diversity of patient encounters are the decisive factors in the development of clinical reasoning competence. Physical real patient encounters are considered optimal, but virtual patient cases also promote clinical reasoning. A high-volume, low-fidelity virtual patient library thus can support clinical reasoning training in a safe environment and can be tailored to the needs of learners from different health care professions. It may also stimulate interprofessional understanding and team shared decisions. Implementation will be challenged by tradition, the lack of educator competence and prior experience as well as the high-density curricula at medical and veterinary schools and will need explicit address from curriculum managers and education leads.

Keywords: education; teaching; clinical reasoning; veterinary; interprofessional; virtual patients
Corresponding author: Thomas Eriksen, Associate Professor, DVM, PhD, Department of Veterinary Clinical Sciences, University of Copenhagen, University Hospital for Companion Animals, 16 Dyrlaegevej, 1870, Frederiksberg C, Denmark, E-mail:

  1. Research ethics: Not applicable.

  2. Informed consent: Not applicable.

  3. Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Competing interests: The authors state no conflict of interest.

  5. Research funding: None declared.

  6. Data availability: Not applicable.

References

1. Larsen, RJ. Shared curricula and competencies in one health and health professions education. Med Sci Educ 2021;31:249–52. https://doi.org/10.1007/s40670-020-01140-7.Search in Google Scholar PubMed PubMed Central

2. Wilkes, MS, Conrad, PA, Winer, JN. One health–one education: medical and veterinary inter-professional training. J Vet Med Educ 2019;46:14–20. https://doi.org/10.3138/jvme.1116-171r.Search in Google Scholar PubMed

3. Acosta, D, Stark, H, Hack, G. The importance of incorporating systems thinking and One Health in global health classrooms: findings from a One Health simulation activity. Front Public Health 2024;12. https://doi.org/10.3389/fpubh.2024.1299116.Search in Google Scholar PubMed PubMed Central

4. De Giusti, M, Barbato, D, Lia, L, Colamesta, V, Lombardi, AM, Cacchio, D, et al.. Collaboration between human and veterinary medicine as a tool to solve public health problems. Lancet Planet Health 2019;3:e64–5. https://doi.org/10.1016/S2542-5196(18)30250-X.Search in Google Scholar PubMed

5. Courtenay, M, Conrad, P, Wilkes, M, La Ragione, R, Fitzpatrick, N. Interprofessional initiatives between the human health professions and veterinary medical students: a scoping review. J Interprof Care 2014;28:323–30. https://doi.org/10.3109/13561820.2014.895979.Search in Google Scholar PubMed

6. Kurtz, S, Silverman, J, Benson, J, Draper, J. Marrying content and process in clinical method teaching: enhancing the Calgary-Cambridge guides. Acad Med 2003;78:802–9. https://doi.org/10.1097/00001888-200308000-00011.Search in Google Scholar PubMed

7. Cockcroft, PD. Clinical reasoning and decision analysis. Vet Clin North Am Small Anim Pract 2007;37:499–520. https://doi.org/10.1016/j.cvsm.2007.01.011.Search in Google Scholar PubMed

8. Henk, HG, Mamede, S. How to improve the teaching of clinical reasoning: a narrative review and a proposal. Med Educ 2015;49:961–73. https://doi.org/10.1111/medu.12775.Search in Google Scholar PubMed

9. Abdul Rahman, NF, Davies, N, Suhaimi, J, Idris, F, Syed Mohamad, SN, Park, S. Transformative learning in clinical reasoning: a meta-synthesis in undergraduate primary care medical education. Educ Prim Care 2023;34:211–19. https://doi.org/10.1080/14739879.2023.2248070.Search in Google Scholar PubMed

10. Hege, I, Adler, M, Donath, D, Durning, S, Edelbring, S, Elvén, M, et al.. Developing a European longitudinal and interprofessional curriculum for clinical reasoning. Diagnosis 2023;10:218–24. https://doi.org/10.1515/dx-2022-0103.Search in Google Scholar PubMed

11. Parodis, I, Andersson, L, Durning, SJ, Hege, I, Knez, J, Kononowicz, AA, et al.. Clinical reasoning needs to be explicitly addressed in health professions curricula: recommendations from a European consortium. Int J Environ Res Public Health 2021;18. https://doi.org/10.3390/ijerph182111202.Search in Google Scholar PubMed PubMed Central

12. Elvén, M, Welin, E, Wiegleb Edström, D, Petreski, T, Szopa, M, Durning, SJ, et al.. Clinical reasoning curricula in health professions education: a scoping review. J Med Educ Curric Dev 2023;10. https://doi.org/10.1177/23821205231209093.Search in Google Scholar PubMed PubMed Central

13. Corrao, S, Argano, C. Rethinking clinical decision-making to improve clinical reasoning. Front Med 2022;9. https://doi.org/10.3389/fmed.2022.900543.Search in Google Scholar PubMed PubMed Central

14. Yazdani, S, Hoseini, AM. Five decades of research and theorization on clinical reasoning: a critical review. Adv Med Educ Pract 2019;10:703–16. https://doi.org/10.2147/AMEP.S213492.Search in Google Scholar PubMed PubMed Central

15. Kozlowski, D, Hutchinson, M, Hurley, J, Rowley, J, Sutherland, J. The role of emotion in clinical decision making: an integrative literature review. BMC Med Educ 2017;17:255. https://doi.org/10.1186/s12909-017-1089-7.Search in Google Scholar PubMed PubMed Central

16. Stolper, CF, van de Wiel, MW. EBM and gut feelings. Med Teach 2014;36:87–8. https://doi.org/10.3109/0142159X.2013.835390.Search in Google Scholar PubMed

17. Vally, ZI, Khammissa, RAG, Feller, G, Ballyram, R, Beetge, M, Feller, L. Errors in clinical diagnosis: a narrative review. J Int Med Res 2023;51. https://doi.org/10.1177/03000605231162798.Search in Google Scholar PubMed PubMed Central

18. Moffett, J, Hammond, J, Murphy, P, Pawlikowska, T. The ubiquity of uncertainty: a scoping review on how undergraduate health professions’ students engage with uncertainty. Adv Health Sci Educ Theory Pract 2021;26:913–58. https://doi.org/10.1007/s10459-021-10028-z.Search in Google Scholar PubMed PubMed Central

19. Brun, C, Zerhouni, O, Akinyemi, A, Houtin, L, Monvoisin, R, Pinsault, N. Impact of uncertainty intolerance on clinical reasoning: a scoping review of the 21st-century literature. J Eval Clin Pract 2023;29:539–53. https://doi.org/10.1111/jep.13756.Search in Google Scholar PubMed

20. Olson, A, Kämmer, JE, Taher, A, Johnston, R, Yang, Q, Mondoux, S, et al.. The inseparability of context and clinical reasoning. J Eval Clin Pract 2024;30:533–8. https://doi.org/10.1111/jep.13969.Search in Google Scholar PubMed

21. Prato-Previde, E, Basso Ricci, E, Colombo, ES. The complexity of the human-animal bond: empathy, attachment and anthropomorphism in human-animal relationships and animal hoarding. Animals 2022;12:2835. https://doi.org/10.3390/ani12202835.Search in Google Scholar PubMed PubMed Central

22. Bouma, EMC, Dijkstra, A, Arnt Rosa, S. Owner’s anthropomorphic perceptions of cats’ and dogs’ abilities are related to the social role of pets, owners’ relationship behaviors, and social support. Animals 2023;13:3644. https://doi.org/10.3390/ani13233644.Search in Google Scholar PubMed PubMed Central

23. Martin, F, Taunton, A. Perceived importance and integration of the human-animal bond in private veterinary practice. J Am Vet Med Assoc 2006;228:522–27. https://doi.org/10.2460/javma.228.4.522.Search in Google Scholar PubMed

24. Mota-Rojas, D, Mariti, C, Zdeinert, A, Riggio, G, Mora-Medina, P, Del Mar Reyes, A, et al.. Anthropomorphism and its adverse effects on the distress and welfare of companion animals. Animals 2021;11:3263. https://doi.org/10.3390/ani11113263.Search in Google Scholar PubMed PubMed Central

25. Kret, ME, Massen, JJM, de Waal, FBM. My fear is not, and never will Be, your fear: on emotions and feelings in animals. Affect Sci 2022;3:182–9. https://doi.org/10.1007/s42761-021-00099.-x.Search in Google Scholar

26. Wieland, B, Daborn, C, Debnath, N, Silva-Fletcher, A. Continuing professional development for veterinarians in a changing world. Continuing professional development for veterinarians in a changing world. Rev Sci Tech 2021;40:555–66. https://doi.org/10.20506/rst.40.2.3245.Search in Google Scholar PubMed

27. Vanhaezebrouck, IF, Scarpelli, ML. Companion animals as a key to success for translating radiation therapy research into the clinic. Cancers 2023;15:3377. https://doi.org/10.3390/cancers15133377.Search in Google Scholar PubMed PubMed Central

28. Brugada-Terradellas, C, Hellemans, A, Brugada, P, Smets, P. Sudden cardiac death: a comparative review of humans, dogs and cats. Vet J 2021;274. https://doi.org/10.1016/j.tvjl.2021.105696.Search in Google Scholar PubMed

29. McDermott, MP, Cobb, MA, Robbé, IJ, Dean, RS. Implications of a novel method for analyzing communication in routine veterinary patient visits for veterinary research and training. J Vet Med Educ 2020;47:709–19. https://doi.org/10.3138/jvme.1018-124r1.Search in Google Scholar PubMed

30. Currier, RW, Steele, JH. One health-one medicine: unifying human and animal medicine within an evolutionary paradigm. Ann N Y Acad Sci 2011;1230:4–11. https://doi.org/10.1111/j.1749-6632.2011.06138.x.Search in Google Scholar PubMed PubMed Central

31. Michell, AR. Comparative clinical science: the medicine of the future. Vet J 2005;170:153–62. https://doi.org/10.1016/j.tvjl.2004.06.004.Search in Google Scholar PubMed

32. King, TA. The One Medicine concept: its emergence from history as a systematic approach to re-integrate human and veterinary medicine. Emerg Top Life Sci 2021;5:643–54. https://doi.org/10.1042/ETLS20200353.Search in Google Scholar PubMed PubMed Central

33. Charlin, B, Lubarsky, S, Millette, B, Crevier, F, Audétat, M, Charbonneau, A, et al.. Clinical reasoning processes: unravelling complexity through graphical representation. Med Educ 2012;46:454–63. https://doi.org/10.1111/j.1365-2923.2012.04242.x.Search in Google Scholar PubMed

34. Eyre, P. Combined veterinary-human medical education: a complete one health degree? J Vet Med Educ 2015;42:283. https://doi.org/10.3138/jvme.0615-093.Search in Google Scholar PubMed

35. Iatridou, D, Bravo, A, Saunders, J. One health interdisciplinary collaboration in veterinary education establishments in Europe: mapping implementation and reflecting on promotion. J Vet Med Educ 2021;48:427–40. https://doi.org/10.3138/jvme-2020-0019.Search in Google Scholar PubMed

36. Fon, NC. UMontrealX: Clinical Reasoning Process. Université de Montréal. https://www.edx.org/learn/medicine/universite-de-montreal-clinical-reasoning-process [Accessed 30 May 2024].Search in Google Scholar

37. Reis-Dennis, S, Gerrity, MS, Geller, G. Tolerance for uncertainty and professional development: a normative analysis. J Gen Intern Med 2021;36:2408–13. https://doi.org/10.1007/s11606-020-06538-y.Search in Google Scholar PubMed PubMed Central

38. Sommers, LS, Launer, J, editors. Clinical uncertainty in primary care. The challenge of collaborative engagement. Springer Science+Business Media New York; 2013.10.1007/978-1-4614-6812-7Search in Google Scholar

39. Dooley, LM, Bamford, NJ. Peer feedback on collaborative learning activities in veterinary education. Vet Sci 2018;5:90. https://doi.org/10.3390/vetsci5040090.Search in Google Scholar PubMed PubMed Central

40. D’Angelo, J, Snyder, M, Bleedorn, J, Hardie, R, Foley, E, Greenberg, JA. An interdisciplinary approach to surgical skills training decreases programmatic costs. J Surg Res 2019;235:600–6. https://doi.org/10.1016/j.jss.2018.10.026.Search in Google Scholar PubMed

41. McKendy, KM, Posel, N, Fleiszer, DM, Vassiliou, MC. A learner-created virtual patient curriculum for surgical residents: successes and failures. J Surg Educ 2016;73:559–66. https://doi.org/10.1016/j.jsurg.2016.02.008.Search in Google Scholar PubMed

42. Rotthoff, T. Practical tips to improve bedside teaching using learning theories and clinical reasoning. MedEdPublish 2024;13:215. https://doi.org/10.12688/mep.19826.2.Search in Google Scholar PubMed PubMed Central

43. Mamede, S, van Gog, T, Sampaio, AM, de Faria, RM, Maria, JP, Schmidt, HG. How can students’ diagnostic competence benefit most from practice with clinical cases? The effects of structured reflection on future diagnosis of the same and novel diseases. Acad Med 2014;89:121–27. https://doi.org/10.1097/ACM.0000000000000076.Search in Google Scholar PubMed

44. Fässler, C, Sinha, T, Schmied, CM, Goldhahn, J, Kapur, M. Problem-solving in virtual environment simulations prior to direct instruction for differential diagnosis in medical education: an experimental study. MedEdPublish 2023;12:61. https://doi.org/10.12688/mep.19348.2.Search in Google Scholar PubMed PubMed Central

45. Urresti-Gundlach, M, Tolks, D, Kiessling, C, Wagner-Menghin, M, Härtl, A, Hege, I. Do virtual patients prepare medical students for the real world? Development and application of a framework to compare a virtual patient collection with population data. BMC Med Educ 2017;17:174. https://doi.org/10.1186/s12909-017-1013-1.Search in Google Scholar PubMed PubMed Central

46. Isaza-Restrepo, A, Gómez, MT, Cifuentes, G, Argüello, A. The virtual patient as a learning tool: a mixed quantitative qualitative study. BMC Med Educ 2018;18:297. https://doi.org/10.1186/s12909-018-1395-8.Search in Google Scholar PubMed PubMed Central

47. Kneebone, R, Baillie, S. Contextualized simulation and procedural skills: a view from medical education. J Vet Med Educ 2008;35:595–8. https://doi.org/10.3138/jvme.35.4.595.Search in Google Scholar PubMed

48. Hege, I, Zary, N, Kononowicz, AA. Criteria to assess the quality of virtual patients. Stud Health Technol Inform 2012;180:954–7.Search in Google Scholar

49. Quail, NPA, Boyle, JG. Virtual patients in health professions education. Adv Exp Med Biol 2019;1171:25–35. https://doi.org/10.1007/978-3-030-24281-7_3.Search in Google Scholar PubMed

50. Kononowicz, AA, Zary, N, Edelbring, S, Corral, J, Hege, I. Virtual patients--what are we talking about? A framework to classify the meanings of the term in healthcare education. BMC Med Educ 2015;15:11. https://doi.org/10.1186/s12909-015-0296-3.Search in Google Scholar PubMed PubMed Central

51. Perioperative interactive education. University Health Network. http://pie.med.utoronto.ca/VIC/ [Accessed 30 May 2024].Search in Google Scholar

52. Edifício Take The Wind. Bodyinteract. https://bodyinteract.com [Accessed 30 May 2024].Search in Google Scholar

53. Instruct gGmbH 2023. https://player.casus.net/pmw2/app/homepage.html [Accessed 30 May 2024].Search in Google Scholar

54. Hornos, E, Pleguezuelos, E, Bala, L, Collares, CF, Freeman, A, van der Vleuten, C, et al.. Reliability, validity and acceptability of an online clinical reasoning simulator for medical students: an international pilot. Med Teach 2024:1–8. https://doi.org/10.1080/0142159X.2024.2308082. Published online March 15.Search in Google Scholar PubMed

55. Kleinsorgen, C, Kankofer, M, Gradzki, Z, Mandoki, M, Bartha, T, von Köckritz-Blickwede, M, et al.. Utilization and acceptance of virtual patients in veterinary basic sciences - the vetVIP-project. GMS J Med Educ 2017;34:Doc19. https://doi.org/10.3205/zma001096.Search in Google Scholar PubMed PubMed Central

56. Moliterno, NV, Paravidino, VB, Robaina, JR, Lima-Setta, F, da Cunha, AJLA, Prata-Barbosa, A, et al.. High-fidelity simulation versus case-based discussion for training undergraduate medical students in pediatric emergencies: a quasi-experimental study. J Pediatr 2024;100:422–9. https://doi.org/10.1016/j.jped.2024.03.007.Search in Google Scholar PubMed PubMed Central

57. Alvarez, E, Nichelason, A, Lygo-Baker, S, Olin, S, Whittemore, J, Ng, Z. Virtual clinics: a student-led, problem-based learning approach to supplement veterinary clinical experiences. J Vet Med Educ 2023;50:147–61. https://doi.org/10.3138/jvme-2021-0144.Search in Google Scholar PubMed

58. Diogo, PG, Pereira, VH, Papa, F, van der Vleuten, C, Durning, SJ, Sousa, N. Semantic competence and prototypical verbalizations are associated with higher OSCE and global medical degree scores: a multi-theory pilot study on year 6 medical student verbalizations. Diagnosis 2023;10:249–56. https://doi.org/10.1515/dx-2021-0048.Search in Google Scholar PubMed

59. Eriksen, T. Simca - det virtuelle case-bibliotek. University of Copenhagen Open Educational Resources 2023. https://oer.ku.dk/media/t/0_fyrgd3x8 [Accessed 30 May 2024].Search in Google Scholar

60. Eriksen, T. Klinisk ræsonnering og differentialdiagnosticering – en kernekompetence. University of Copenhagen Open Educational Resources; 2020. https://oer.ku.dk/media/t/0_1l4nigs8 [Accessed 30 May 2024].Search in Google Scholar

61. Teixeira Ferraz Grünewald, S, Grünewald, T, Ezequiel, OS, Lucchetti, ALG, Lucchetti, G. One-minute preceptor and SNAPPS for clinical reasoning: a systematic review and meta-analysis. Intern Med J 2023;53:680–9. https://doi.org/10.1111/imj.16005.Search in Google Scholar PubMed

62. Flores-Cohaila, JA, Vizcarra-Jiménez, SF, Bermúdez-Peláez, MF, Vascones-Román, FF, Rivarola-Hidalgo, M, Taype-Rondan, A. Effects of SNAPPS in clinical reasoning teaching: a systematic review with meta-analysis of randomized controlled trials. Diagnosis 2024;https://doi.org/10.1515/dx-2023-0149. Published online March 7.Search in Google Scholar PubMed

63. McGinn, K. Silos in education are the main barrier to collaboration. Vet Rec 2015;176:419. https://doi.org/10.1136/vr.h1928.Search in Google Scholar PubMed

64. Englar, RE, Show-Ridgway, A, Noah, DL, Appelt, E, Kosinski, R. Perceptions of the veterinary profession among human health care students before an inter-professional education course at midwestern university. J Vet Med Educ 2018;45:423–36. https://doi.org/10.3138/jvme.1016-161r1.Search in Google Scholar PubMed

65. Vreugdenhil, J, Somra, S, Ket, H, Custers, EJFM, Reinders, ME, Dobber, J, et al.. Reasoning like a doctor or like a nurse? A systematic integrative review. Front Med 2023;10. https://doi.org/10.3389/fmed.2023.1017783.Search in Google Scholar PubMed PubMed Central

66. Johnson, LM, Ames, TR, Jacko, JA, Watson, LA. The informatics imperative in veterinary medicine: collaboration across disciplines. J Vet Med Educ 2011;38:5–9. https://doi.org/10.3138/jvme.38.1.5.Search in Google Scholar PubMed

67. Roopnarine, R, Regan, JA. Faculty perceptions: a qualitative study of the perceived need, opportunities, and challenges of developing “one health-one medicine” in the medical, veterinary, and public health curricula. J Contin Educ Health Prof 2021;41:16–23. https://doi.org/10.1097/CEH.0000000000000332.Search in Google Scholar PubMed

68. Estrada, AH, Behar-Horenstein, L, Estrada, DJ, Black, E, Kwiatkowski, A, Bzoch, A, et al.. Incorporating inter-professional education into a veterinary medical curriculum. J Vet Med Educ 2016;43:275–81. https://doi.org/10.3138/jvme.0715-121R.Search in Google Scholar PubMed

69. Srinivasan, M, Pratt, DD, Collins, J, Bowe, CM, Stevenson, FT, Pinney, SJ, et al.. Developing the master educator: cross disciplinary teaching scholars program for human and veterinary medical faculty. Acad Psychiatry 2007;31:452–64. https://doi.org/10.1176/appi.ap.31.6.452.Search in Google Scholar PubMed

Received: 2024-03-17
Accepted: 2024-06-13
Published Online: 2024-07-05

© 2024 Walter de Gruyter GmbH, Berlin/Boston

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  11. Original Articles
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  23. Case Report – Lessons in Clinical Reasoning
  24. Lessons in clinical reasoning – pitfalls, myths, and pearls: a case of persistent dysphagia and patient partnership
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https://doi.org/10.1515/dx-2024-0059
Keywords for this article
education; teaching; clinical reasoning; veterinary; interprofessional; virtual patients

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Should APTT become part of thrombophilia screening?
  4. Review
  5. n-3 fatty acids and the risk of atrial fibrillation, review
  6. Guidelines and Recommendations
  7. Root cause analysis of cases involving diagnosis
  8. Opinion Papers
  9. What is diagnostic safety? A review of safety science paradigms and rethinking paths to improving diagnosis
  10. Interprofessional clinical reasoning education
  11. Original Articles
  12. Quality of heart failure registration in primary care: observations from 1 million electronic health records in the Amsterdam Metropolitan Area
  13. Typology of solutions addressing diagnostic disparities: gaps and opportunities
  14. Diagnostic errors and characteristics of patients seen at a general internal medicine outpatient clinic with a referral for diagnosis
  15. Cost-benefit considerations of the biased diagnostician
  16. Delayed diagnosis of new onset pediatric diabetes leading to diabetic ketoacidosis: a retrospective cohort study
  17. Monocyte distribution width (MDW) kinetic for monitoring sepsis in intensive care unit
  18. Are shortened aPTT values always to be attributed only to preanalytical problems?
  19. External Quality Assessment (EQA) scheme for serological diagnostic test for SARS-CoV-2 detection in Sicily Region (Italy), in the period 2020–2022
  20. Recent mortality rates due to complications of medical and surgical care in the US
  21. Short Communication
  22. The potential, limitations, and future of diagnostics enhanced by generative artificial intelligence
  23. Case Report – Lessons in Clinical Reasoning
  24. Lessons in clinical reasoning – pitfalls, myths, and pearls: a case of persistent dysphagia and patient partnership
  25. Letters to the Editor
  26. The ‘curse of knowledge’: when medical expertise can sometimes be a liability
  27. A new approach for identifying innate immune defects
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