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Josepha Kuhn PhD candidate

Clinical reasoning

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My research project is about testing ways to improve the clinical reasoning education for general practitioners in training. In three studies, we tested different ways to teach them a procedure to engage in more analytical, reflective reasoning when diagnosing cases. Previous studies have found, that this Deliberate Reflection procedure can help physicians to correct diagnostic mistakes, that they may make initially. We tested different types of interventions, which were learning-by-doing, example-based learning, and learning-by-teaching. In a fourth study, we tested whether we could help general-practitioners in training to better estimate how well they have diagnosed a case. Reducing overconfidence in a wrong diagnosis or underconfidence in a correct diagnosis, could help them to make less errors in clinical practice. However, this intervention proved to be ineffective.

While our interventions to teach reflective reasoning were ineffective when we tried them with residents in general practice, we did find an effect with students. This may mean that teaching cognitive strategies should be done early in the education. As soon as they gain more experience and develop their own routine in diagnosing patients, it is difficult to change anything about that.

I hope that my research can make a contribution to what we know about effective training in clinical reasoning. Personally, my PhD project helps me to improve my research and organizational skills.


Anyone with questions about clinical reasoning, instructional design, and quantitative research could get in touch with me.