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    Item type:Publication,
    Simulation scenario design model for training clinical reasoning in undergraduate medical students
    (2023)
    Soledad Armijo Rivera
    ;
    Cristian Labarca Solar
    ;
    Cristian Pérez Villalobos
    ;
    Claudia Behrens Pérez
    ;
    Catalina Tamburrino Díaz
    <jats:p>Introduction: Clinical reasoning is a complex task that physicians use when treating patients, and it can be carried out through intuitive and analytical processes. Clinical simulation is a tool to train reasoning, however, its evaluation remains challenging. In the present study, we evaluated the scenario design template for clinical reasoning associated with using an observation scale applied to medical students in two sequential simulation scenarios. Materials and methods: Two simulation scenarios with 4 levels of complexity were designed to manage sepsis in adult patients, where 12 groups of 8 students participated. These simulations were recorded and later analyzed by qualified observers through a guideline built on the conceptual proposals of Croskerry, Braun, and Pennaforte. Results: The scenarios were carried out in an average of 12 minutes. Most students established the diagnosis and initial management through the partial collection of information, showing control of intuitive reasoning in 98 % of the cases, whereas only 10,4 % achieved the analytical processes. Conclusion: The design of simulation scenarios composed of different levels of complexity could promote the development of clinical reasoning. Using an observation guideline allowed the analysis of the clinical reasoning process in realistic environments and without interruptions and could be used to guide debriefings.</jats:p>
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    Remote simulation: A qualitative study on clinical reasoning and cognitive errors from the students' perspective
    (2023)
    Verónica Mir-Bezanilla
    ;
    Antonia González-Bernstein
    ;
    María Ignacia Lüer-Sepúlveda
    ;
    Rosario López-Leiva
    ;
    Joaquín Díaz-Schmidt
    <jats:p>Introduction: Clinical reasoning is a crucial competency for medical practice and also a complex theory that is susceptible to cognitive errors. It is usually taught with clinical cases, in clinical settings, without technologies and in a practical manner rather than from a conceptual perspective. Given the need to improve its teaching in the undergraduate medical curriculum during the pandemic, we hypothesized that medical students participating in an online simulation and reflective practice course could benefit from a practical and theoretical approach to the clinical reasoning process. Material and Methods: A four-week online course, based on synchronous and asynchronous online simulation and reflective practice, was developed to promote metacognition among participants. The course was delivered to 8 sixth-year medical students as an elective module. A questionnaire consisting of four open-ended questions was designed to explore knowledge about clinical reasoning and cognitive errors, and was administered at the beginning and end of the course. A qualitative analysis of the responses was carried out using Berelson's content analysis method. Results: At the end of the course, students changed their understanding of the concept of clinical reasoning, considering it more as a process and identifying the dual nature described in one of the theories of clinical decision making.  They also changed their knowledge of cognitive errors, attributing them not only to lack of knowledge, and understanding that they can actively use some strategies to reduce cognitive biases. Discussion: This study confirms that undergraduate students positively change their concept of clinical reasoning and their knowledge about this cognitive process and the cognitive errors that occur in it after a course that includes online simulation and reflection.</jats:p>
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    Item type:Publication,
    Telesimulación y teledebriefing para promover el razonamiento clínico en estudiantes de pregrado de medicina
    (2021)
    Marco Ortiz-Arévalo
    ;
    Trinidad Campusano-Schialer
    ;
    Alvaro Tolosa-Villarreal
    ;
    Adriel Marco
    ;
    Soledad Armijo-Rivera
    Scopus© Citations 4  2