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Reflecting on exchanged students' learning: bedside demonstration, case reporting and clinical reasoning

Author: 
Dan Xu, Shaoting Feng, Shuqin Ding, Timothy Yap, Christopher Chi, Nicole Tan, Ankith Nair, Dennis Nixon, Cleo Wee, Johan Rosman, Jingsong Wang, Ming Kuang and Haipeng Xiao
Subject Area: 
Health Sciences
Abstract: 

Introduction: The increasing opportunities for medical students to participate in international, supervised and structured electives have been evidenced to enhance medical students’ professionalism, cultural competence and clinical reasoning (CR) skills in preclinical years. Evidence is scant in achieving the specific learning objectives and improving CR during senior-years. This study evaluates how supervised elective can improve medical students’ CR skills through bedside demonstration, case presentation and reporting. Methods: This qualitative pilot study recorded daily bedside discussions and cases collections with six students during international elective in a focus-group style. The recorded CR discussions and case collections form the students’ reflective themes including CR learning, journal case report writing and impact on ongoing learning. The individual interview design is based on SNAPPS feedback tool and PICO framework. We also collected 6-months/18-months/30-months post-elective reflections for evaluating longer-term academic impact of the elective. Results: The five domains of CR learning identified in daily students-supervisors discussions were reflected in-depth by students, and pedagogically evaluated by supervisors in a focus-group style and individual interview. The SNAPPS feedback tool and PICO framework enabled students’ completion of case reports for successful journal publication. Students’ reflections on their learning at the time of the exchange, 6-months, 18-months and 30-months post-exchange have demonstrated that the elective can improve CR skill learning, case report writing skill, clinical competency. Conclusions: This study demonstrated through students’ reflections that SNAPPS feedback tool and PICO framework are most valuable for CR learning, case presentation and reporting. The students’ reflections have provided insight into how this elective can improve students’ CR learning, enhance academic writing skills and facilitate competent clinical practice as junior doctors.

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