Facilitating clinical reasoning for medical students in clinical settings: a scoping review

Abstract

This scoping review describes the responsibilities of facilitators, especially clinical teachers, in facilitating clinical reasoning and factors affecting the implementation of the strategies. This review was conducted by collecting and identifying original data in peer-reviewed full English journals published between 2004 and 2021. It followed Arksey and O’Malley’s framework and adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. The process included formulating review questions, developing a comprehensive search strategy, selecting relevant studies, extracting data, and presenting findings. Initial searches were conducted on PubMed, EBSCO, Scopus, and EMBASE, with a research librarian ensuring the efficiency and comprehensiveness of the search. The search based on the PCC approach (population, concept, context approach) encompassed “clinical reasoning,” “facilitation,” and “clinical teachers.” Out of the initial 2,004 records retrieved from the four databases, a thorough screening process led to the 30 studies included in the review, revealing three primary themes and multiple strategies related to clinical reasoning facilitation in clinical settings. These themes involved the responsibilities of clinical teachers, strategies utilized, and factors influencing clinical reasoning learning in clinical settings. In the clinical settings, clinical teachers have crucial responsibilities in facilitating clinical reasoning learning, including creating a safe environment, demonstrating effective practices, using appropriate strategies, and assessing students’ abilities. While this review has explored the responsibilities of clinical teachers, specific strategies that enhance clinical reasoning abilities need further investigation. Additionally, the impacts of identified factors on strengthening clinical reasoning abilities require more analysis.