Article
A Novel Approach for the Analysis of Scientific Reasoning and Argumentation in Clinical Case Discussions
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Published: | March 1, 2018 |
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Introduction: Scientific reasoning and argumentation (SRA) has been described as a compound of scientific discovery, scientific argumentation, and the understanding of the nature of science [1], [5]. This pilot study aimed to investigate SRA skills of medical students participating in Clinical Case Discussions (CCD), a peer teaching format designed to foster SRA activities such as evidence evaluation or hypothesis generation (cf. [2]).
Methods: We recruited 15 volunteer medical students (Mage=22.9 years, SD=2.2 years; 66% female; Mstudy year=3.7, SD= 0.9) of LMU Munich in the clinical phase of their studies (3rd to 6th year). These students participated in three CCD sessions which followed an admission-, discussion-, and summary-sequence respectively. CCD sessions typically lasted 90 to 120 minutes. Discussions were videotaped as well as audio-recorded and then transcribed. A content-analytic SRA coding-scheme that had previously been applied in the domain of social work [3] was adapted for the medical education context.
Results: Overall, participants in the CCD engaged themselves predominantly in SRA activities evidence generation (EG, 34%), communicating/scrutinising (CS, 26.2%), questioning (Q, 22.4%) and evidence evaluation (EE, 12.4%). The peer‐teachers were drivers of EG, CS and Q, whereas students engaged mostly in EE, hypothesis generation (HG), drawing conclusions (DC), and problem identification (PI).
Discussion: Our pilot study demonstrated that an in-depth analysis of SRA activities is feasible. The successful adaptation of a content-analytic SRA coding scheme from the domain of social work further supports the notion of a cross-domain validity of SRA activities as introduced in the framework by Fischer and colleagues [2]. The CCD triggered valuable SRA activities, underlining that this may be an appropriate teaching format to teach clinical reasoning skills to medical students as clinical reasoning can be seen as a specific kind of SRA [4].
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