OBJECTIVE: Clinical reasoning is usually taught using a problem-solving approach, which is widely adopted in medical education. However, learning through problem solving is difficult as a result of the contextualization and dynamic aspects of actual problems. Moreover, knowledge acquired from problem-solving practice tends to be inert and fragmented. This study proposed a computer-based cognitive representation approach that externalizes and facilitates the complex processes in learning clinical reasoning. The approach is operationalized in a computer-based cognitive representation tool that involves argument mapping to externalize the problem-solving process and concept mapping to reveal the knowledge constructed from the problems.METHODS: Twenty-nine Year 3 or higher students from a medical school in east China participated in the study. Participants used the proposed approach implemented in an e-learning system to complete four learning cases in 4 weeks on an individual basis. For each case, students interacted with the problem to capture critical data, generate and justify hypotheses, make a diagnosis, recall relevant knowledge, and update their conceptual understanding of the problem domain. Meanwhile, students used the computer-based cognitive representation tool to articulate and represent the key elements and their interactions in the learning process.RESULTS: A significant improvement was found in students' learning products from the beginning to the end of the study, consistent with students' report of close-to-moderate progress in developing problem-solving and knowledge-construction abilities. No significant differences were found between the pretest and posttest scores with the 4-week period. The cognitive representation approach was found to provide more formative assessment.CONCLUSIONS: The computer-based cognitive representation approach improved the learning of clinical reasoning in both problem solving and knowledge construction.
B., W., M., W., J.M., J., & T.A., G. (2014). Improving the learning of clinical reasoning through computer-based cognitive representation. Medical Education Online, 19, 25940. Retrieved from http://linker2.worldcat.org/?rft.institution_id=129664&spage=25940&pkgName=UKPMC&linkclass=to_article&jKey=1077&provider=NLM&date=2014&aulast=Wu+B.%3B+Wang+M.%3B+Johnson+J.M.%3B+Grotzer+T.A.&atitle=Improving+the+learning+of+clinical+reasoning+through+comp