Can Clinical Reasoning Deficits Be Remediated?

clinical_reasoning  Yes, is the resounding answer from Dr. Guerrasio, who literally wrote the book on medical learner remediation.  The authors describe their institution’s experience remediating learners identified as having deficiency in clinical reasoning, most with co-existing deficits in other domains as well.  Of 53 such learners, 96% passed a blinded reassessment and 91% continued successfully in their programs.  They describe a time-intensive program in which learners create extensive tables for “all the main presentations for that specialty”, including illness scripts with semantic qualifiers, diagnostic testing, and treatment algorithms.  The median number of faculty hours expended per learner was 18, with a range up to 100 hours, excluding time for “planning, assessment, or preparation.” — Laura Willett, MD


Guerrasio J, Aagaard EM., Methods and outcomes for the remediation of clinical reasoning. J Gen Intern Med. 2014 Dec;29(12):1607-14.

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