To achieve the goals for the Clinical Reasoning Course, students learn a structured approach to medical problem solving that emphasizes the process skills, and combines self-regulation with collaborative/facilitated learning components. The idea is to promote deliberative self-regulation as well as the consultation of colleagues' ideas and perspectives while using a systematic approach to problem-solving.
The key to teaching problem-solving is effective problem-construction based on real-world situations that evince a range of cognitive dimensions and provide a framework or structure for solving them (Jonassen, 2000; also 2010).
The UA COM approach incorporates this stance in its structured approach to medical problem-solving, a hybrid of scientific method and Polya's (1954) model for problem-solving. (Learn more about Polya's approach)
This 5-step medical problem-solving structure we use in the Clinical Reasoning Course (Figure below) is also inspired by the concept of evidence-based decision making, and is aligned with learning theory that underlies the developmental curriculum at the UA College of Medicine.
Problem-solving Step by Step
Each "step" focuses on the process of generating a desired outcome. For example, when students formulate hypotheses and articulate their reasoning for each, they are generating a list of provisional diagnoses.
We emphasize process by naming the step for how students will engage in producing that outcome, and not by the outcome itself.
By the time students work through a case they will have engaged in the kind of thinking and critical reflection highlighted by each step.
Why a structured approach?
The purpose of using a structured approach to medical problem-solving is to scaffold students' internalization of a systematic approach to clinical reasoning.
As students progress toward clinical years, they will need less scaffolding and greater challenges. The Clinical Reasoning Course is a longitudinal learning experience that expects to apply and extend what they are learning throughout the curriculum. The course is designed to increase challenges in content as well as the type of critical thinking and reflective reasoning.
Students use an online tool that visualizes this structure, allowing them to share what they think, and learn how peers develop their thinking in each case.
5-Step Guide Polya-How to Solve it Cognitive Error Dr. Putnam on the 5-steps