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Carr, A.(.N.; Ferlini Agne, G.; Kirkwood, R.N.; Petrovski, K.R. Teaching Clinical Reasoning to Veterinary Medical Learners with a Case Example. Encyclopedia. Available online: https://encyclopedia.pub/entry/56627 (accessed on 16 November 2024).
Carr A(N, Ferlini Agne G, Kirkwood RN, Petrovski KR. Teaching Clinical Reasoning to Veterinary Medical Learners with a Case Example. Encyclopedia. Available at: https://encyclopedia.pub/entry/56627. Accessed November 16, 2024.
Carr, Amanda (Mandi) Nichole, Gustavo Ferlini Agne, Roy Neville Kirkwood, Kiro Risto Petrovski. "Teaching Clinical Reasoning to Veterinary Medical Learners with a Case Example" Encyclopedia, https://encyclopedia.pub/entry/56627 (accessed November 16, 2024).
Carr, A.(.N., Ferlini Agne, G., Kirkwood, R.N., & Petrovski, K.R. (2024, May 10). Teaching Clinical Reasoning to Veterinary Medical Learners with a Case Example. In Encyclopedia. https://encyclopedia.pub/entry/56627
Carr, Amanda (Mandi) Nichole, et al. "Teaching Clinical Reasoning to Veterinary Medical Learners with a Case Example." Encyclopedia. Web. 10 May, 2024.
Peer Reviewed
Teaching Clinical Reasoning to Veterinary Medical Learners with a Case Example
This is a peer-reviewed entry published in Encyclopedia Journal, full entry can be found at 10.3390/encyclopedia4020048

Clinical reasoning is an essential competence of veterinary graduands. It is a complex competence with cognitive, metacognitive, social, and situational activities. The literature on clinical reasoning in veterinary medical education is relatively scarce or focused on theoretical rather than practical applications. In this review, we address the practicality of teaching clinical reasoning to veterinary learners utilizing a practical example of a cow with allergic rhinitis. Learners should be guided through all the domains of clinical reasoning, including concepts, data collection and analysis, take action, and reflection on an encounter. Each of these domains needs to be clearly but concisely explained and practiced repeatedly by learners throughout the veterinary curricula. The teaching of clinical reasoning should start as early in the curriculum as possible, preferably in the pre-clinical years, with a gradual scaffolding and building of complexity before work-based learning begins, with an increase in demanding for advanced clinical reasoning competence. The teaching of clinical reasoning is best performed in specialized sessions and continued as a horizontally and vertically integrated activity.

clinical teaching veterinary learners instructors clinical encounter deep learning
Accurate diagnosis and appropriate management of the clinical encounter are essential to the provision of quality veterinary medical services. Diagnostic accuracy is heavily reliant on the ability to reason based on the clinical presentation of the patient [1]. Most clinical reasoning errors are not the result of a lack of knowledge but rather reflect the complexity of the clinical presentation coupled with minor to major faults in cognition or contextualization of the clinical encounter, and the defective synthesis of information [1][2][3][4][5][6][7][8][9][10][11]. Errors in clinical reasoning, particularly in diagnosis, in human medicine range between 4% and 25% [3][12][13][14], with errors in adherence to best practice reaching up to 45% [3]. Some 30–70% of these errors are preventable [6][13]. These error proportions are probably similar in veterinary medical practice [15], emphasizing the importance of learning the clinical reasoning process for veterinary learners [16][17][18][19][20][21][22]. Clinical reasoning is also considered an essential requirement by many accreditation bodies of veterinary medical educators [23][24][25].
The learning and teaching of clinical reasoning has been an area of significant importance in other medical fields [26], starting with the pioneering work of Ledley and Lusted in the 1950s [27], followed by the seminal work of Elstein in the 1970s [28]. Instructors and learners in various medical fields, including veterinary medicine, have stated that the learning and teaching of clinical reasoning are challenging (Table 1). The challenge derives from the complexity of what the clinical reasoning process entails [9][10][29][30]. However, the process can be simplified into three basic concepts—clinical reasoning as a (1) cognitive and metacognitive activity; (2) contextually situated activity; and (3) socially mediated activity [12][31][32].
Table 1. Reasons for finding teaching or learning clinical reasoning challenging.

Instructors

Learners

Ambiguity and complexity of the process

[22][30][33][34][35]

Being at level of educator in (O)RIME and using a lot of intuitive types of clinical reasoning

[36]

Curriculum design lacking stimulation of storage of knowledge in clinically relevant manner

[30][36][37][38]

Difficulty in explanation of cognitive processing of information to learner/s

[34][36][37]

Lack of awareness of clinical reasoning concepts

[35]

Lack of consideration of the clinical reasoning process when dealing with clinical encounters

[39]

Lack of training in teaching clinical reasoning

[30][34][35][37]

Relative lack of literature in journals frequently read by instructors involved with clinical teaching that are not directly employed in academia

[34][36]

Ambiguity and complexity of the process

[22][30][33][35]

Being at levels lower than educator and using a lot the analytical type of clinical reasoning

[36]

Being unfamiliar with the work-based learning context

Belief that clinical reasoning is ‘an art’

[36]

Content-loaded curriculum

[38]

Curriculum design lacking stimulation of storage of knowledge in clinically relevant manner

[30][36][37][38]

Lack of ‘real-life’ situations training during theoretical portion of the curriculum

[40]

Lack of awareness of clinical reasoning concepts

[35]

Lack of confidence

[38]

Lack of explanation of cognitive processing of information by instructor/s

[37][39][41]

Lack of opportunities to practice clinical reasoning in safe environment

[37][38]

Lack of qualified instructors in teaching clinical reasoning

[37][38]

Lack of specific teaching of clinical reasoning processes

[30][38][40]

Late introduction of clinical reasoning into the curriculum

[40]
We found scarce literature related to teaching clinical reasoning related to veterinary medical education and, as such, the statements used will be predominantly evidence-based literature related to medical professions. The clinical instructor (instructor hereafter) plays a double role in the teaching of clinical reasoning, a clinician and a pedagogist [35]. We would like to stress that our recommendations in teaching clinical reasoning are dependent on the appropriate training of these instructors in clinical teaching, and, in particular, clinical reasoning.

References

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Subjects: Veterinary Sciences
Contributors MDPI registered users' name will be linked to their SciProfiles pages. To register with us, please refer to https://encyclopedia.pub/register :
Amanda (Mandi) Nichole Carr
,
Gustavo Ferlini Agne
,
Roy Neville Kirkwood
,
Kiro Risto Petrovski
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Online Date: 10 May 2024
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