scholarly journals Comparative analyses of knowledge, attitude and practice of medical undergraduates and early career doctors about the use of clinical reasoning as a tool for medical diagnosis and management

2020 ◽  
Vol 47 (2) ◽  
pp. 79-84
Author(s):  
I.E. Yarhere ◽  
D.C. Briggs ◽  
C. Okechukwu ◽  
C. Ogbonnaa-Njoku

Introduction: Developing the skills of clinical reasoning is a tedious process, especially for the novice learner and requires practice. The clinical reasoning skill is a cognitive process of systematic clinical decision making needed to reduce diagnostic errors. A clinical reasoning tool for diagnosis using the Bloom’s taxonomy of critical thinking has been in use in the Paediatrics Department of the University of Port Harcourt. However, little is known about the difficulties encountered by trainees (medical students and early career doctors) while using the tool during dailyclinical clerkship. We aimed to determine aspects of the clinical reasoning process trainees find difficult and ways to make this easier. Methods: A well-structured, pretested questionnaire was administered to 67 medical undergraduates and 99 early career medical doctors which assessed responses to the definition of clinical reasoning, matching Bloom’s taxonomy hierarchy with steps in clinical reasoning, functional andstructural abnormalities and attitudes towards the use of the clinical reasoning tool. The Likert 5 point scale tool was used to assess attitudes and practice difficulties during the use of the tool. The differences in responses were tested for significance using Student’s T test, and Chi squared test,with p values <0.05 as significant. Results: Of the 166 respondents analysed, 103 (62%) got the correct definition of clinical reasoning with early career doctors having a higher  proportion of correct respondents, χ2 = 4.59, p = 0.032. Specific areas of difficulties identified were with making clinical diagnosis in 50 (30.1%) and pathologic diagnosis (es) in 38 (22.9%). Ninety-nine (59.6%) responded that clinical reasoning was time consuming and 42 (25.3%) thought it was difficult to practice in a busy clinic. One hundred and six (64.1%) respondents suggested a view of basic clinical studies before starting clinical   practice in order to improve clinical reasoning. Conclusion/Recommendation: Making clinical diagnosis is difficult for the clinical trainee while using the clinical reasoning tool, therefore the  clinical teacher should help trainees move from one cognitive level to the next until the trainee can create logical conclusions from information gathered following clerking. Keywords: Clinical reasoning, critical thinking, medical students, interns

2016 ◽  
Vol 4 (2) ◽  
pp. 163
Author(s):  
Norwanto Norwanto

Critical thinking includes a process of reasoning in thinking as stated by some scholars. In the process, there is universal standard to follow: clarity, accuracy, precision, relevance, depth, breadth, logic, and fairness. In language classes, critical thinking creates active classes. To bring critical thinking to classes, Bloom’s Taxonomy and critical thinking strategies can be working definition in order critical thinking to be applied to pedagogical materials in a practical way. Steps for critical thinking teaching includes five steps: (1) determining learning objectives, (2) teaching through questioning, (3) practicing before assessing, (4) reviewing, refining, and improving, and (5) providing feedback and assessment of learning. A lesson plan should reflect these five steps.Keywords: Critical Thinking; Language Teaching; Lesson Plan; Bloom’s Taxonomy; Critical Thinking Strategies


Humaniora ◽  
2010 ◽  
Vol 1 (2) ◽  
pp. 359
Author(s):  
Dominikus Tulasi

This article would like to share the use of Bloom's taxonomy as a cognitive framework for teaching-learning process to undertake the way student-centered learning. Related to the curriculum based competence in excellent education, the abstract cognitive in applying Bloom’s taxonomy is so called scaffolding. We know the taxonomy Bloom is a six-level classification system that uses observed student behavior to infer and absorb the level of cognitive achievement domain. This article surveys thinking within general education and management education, which uses and draws on Bloom's taxonomy, and then describes suggested uses of the taxonomy. The empirical evaluation of its effect on student achievement follows, as do thoughts about ways colleagues might use this tool to empower and motivate students as self-responsible learners in the classroom. The objective is to promote higher order thinking in college students, we understood an effort to learn how to assess critical-thinking skills in an introductory course. It means, we develop a process by which questions are prepared with both content and critical-thinking skills in mind. 


2019 ◽  
Vol 4 (1) ◽  
pp. 39
Author(s):  
Mohsine Jebbour

The purpose of this study was to explore whether Ticket 2 English, Moroccan textbook of English, includes elements of critical thinking, which refers to the skill and disposition to select, collect, analyze, and evaluate information effectively. Descriptive analysis was employed to document instructions and activities that support the inclusion of CT elements in the textbook. Results suggest that Ticket 2 English includes most of the skills found in Bloom’s taxonomy, important critical thinking dispositions, and some activities for teaching critical thinking. Yet, textbook designers need to supplement textbooks of English with additional activities, and high school teachers of English need to implement new teaching materials and practices to help enhance students’ level of critical thinking.


Author(s):  
Sónia Rolland Sobral ◽  

Students in computer science courses entering higher education begin with computer thinking and programming languages in a curricular unit (CU) that can be referred to in various ways, like CS1 or programming fundamentals. This CU is very important for the academic and professional path of those students. Teachers and those responsible for those courses must carefully define the learning objectives, the learning strategies and the assessment of this teaching-learning. Bloom's taxonomy, in its different variations, is a powerful tool that helps in these tasks and that gives clear indications on the language that is to be used - which is useful for perceiving both the level of colleagues and the level of accreditations and assessments of courses. This article provides a detailed description of Bloom's taxonomy and its changes over the years. Studies carried out in the context of teaching fundamentals of programming and using Bloom's taxonomy are listed and analyzed. In the end, the conclusions and the definition of future works are made.


2021 ◽  
Author(s):  
Kiyoshi Shikino ◽  
Claudia A Rosu ◽  
Daiki Yokokawa ◽  
Shingo Suzuki ◽  
Yusuke Hirota ◽  
...  

Abstract BACKGROUND: Training for the fundus examination using traditional teaching is challenging, resulting in low generalist physicians’ confidence in performing the funduscopic exam. At the same time, there is growing evidence suggesting flipped classrooms’ value in teaching physical examination procedures. However, whether the flipped classroom is superior to the traditional, lecture-based teaching for the funduscopic exam and the cognitive processes supporting its effectiveness has not yet been determined. METHODS: We conducted a sequential explanatory mixed-method study to compare the flipped classroom approach’s effectiveness versus the traditional lecture-based classroom for teaching the funduscopic exam to the medical students at Chiba University in Japan. Medical students were randomly assigned to either a flipped classroom group or a traditional teaching group. We then quantitatively measured the diagnostic accuracy of funduscopic findings, the length of time to perform the fundus examination, and students’ confidence in performing funduscopic examinations, before and after attending the specific classrooms. Next, we conducted student focus groups to explore the students’ thinking processes in the flipped classroom and traditional teaching of fundus examination, respectively. The qualitative data were analyzed using the qualitative content analysis method.RESULTS: Diagnostic accuracy was significantly higher using the flipped classroom method (flipped: 36.6% to 63.4%, traditional: 28.3% to 34.6%, F (1,310) = 11.0, p = .001). The total examination time was significantly shorter using the flipped classroom teaching (flipped: 85.4s to 66.9s, traditional: 85.3s to 76.3s, F (1,310) = 14.7, p <.001). Six semi-structured focused group interviews were conducted (n=36). In the flipped classroom group, we identified 12 categories corresponding to five levels of the revised Bloom’s taxonomy: remember, understand, apply, analyze, evaluate. Five categories were identified in the traditional classroom group corresponding only to three levels of the revised Bloom’s taxonomy: understand, apply, analyze. Interrater reliability was substantial (Cohen’s kappa = 0.81). CONCLUSIONS: Teaching medical students funduscopic examination using the flipped classroom methodology leads to improved diagnostic accuracy, confidence, and motivation for funduscopic examinations, while reducing total examination time. The flipped classroom teaching method enabled higher levels of cognitive activity than the traditional, lecture-based classroom, as assessed using the revised Bloom’s taxonomy.


1980 ◽  
Vol 4 (1) ◽  
pp. 17-26 ◽  
Author(s):  
Carolyn M. Callahan ◽  
Mary L. Corvo

The present research assessed the structural validity of The Ross Test of Higher Cognitive Processes, a recently developed instrument designed to assess the higher-level thinking skills of analysis, synthesis and evaluation as outlined in Bloom's Taxonomy. Confirmatory factor analysis, analysis of variance and trend analysis were used to test the correspondence between Bloom's Taxonomy and the Ross Test, and to study the developmental nature of critical thinking. Subjects were 154 gifted third through sixth graders. Confirmatory factor analysis of individual test items and of the eight Ross subtests provided empirical evidence for the structural validity of this instrument, and normative data on gifted students' performance on the test was presented. This investigation of the Ross Test yielded findings relevant to the use and interpretation of this measure of critical thinking in the gifted and regular classroom.


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