This book is open access under a CC BY 4.0 license.
This volume describes and explains the educational method of Case-Based Clinical Reasoning (CBCR) used successfully in medical schools to prepare students to think like doctors before they enter the clinical arena and become engaged in patient care. Although this approach poses the paradoxical problem of a lack of clinical experience that is so essential for building proficiency in clinical reasoning, CBCR is built on the premise that solving clinical problems involves the ability to reason about disease processes. This requires knowledge of anatomy and the working and pathology of organ systems, as well as the ability to regard patient problems as patterns and compare them with instances of illness scripts of patients the clinician has seen in the past and stored in memory. CBCR stimulates the development of early, rudimentary illness scripts through elaboration and systematic discussion of the courses of action from the initial presentation of the patient to the final steps of clinical management.
The book combines general backgrounds of clinical reasoning education and assessment with a detailed elaboration of the CBCR method for application in any medical curriculum, either as a mandatory or as an elective course. It consists of three parts: a general introduction to clinical reasoning education, application of the CBCR method, and cases that can used by educators to try out this method.
PART I: Backgrounds of educating preclinical students in clinical reasoning
.- 1. Introduction; Olle ten Cate.- 2. Training clinical reasoning: historical and theoretical background; Eugène J.F.M. Custers.- 3. Understanding clinical reasoning from multiple perspectives: a conceptual and theoretical overview; Olle ten Cate & Steven Durning.- 4. Prerequisites for Learning Clinical Reasoning; Judith L. Bowen & Olle ten Cate.- 5. Approaches to assessing the clinical reasoning of preclinical students; Olle ten Cate & Steven J. Durning.- PART II: The method of Case-Based Clinical Reasoning education
.- 6. Case-based Clinical Reasoning in practice; Angela van Zijl, Maria van Loon & Olle ten Cate.- 7. Assessment of clinical reasoning in a CBCR course; Olle ten Cate.- 8. Writing CBCR cases; Olle ten Cate & Maria van Loon.- 9. Curriculum and faculty development for Case-based Clinical Reasoning; Olle ten Cate & Gaiane Simonia.- 10. A model study guide for Case-based Clinical Reasoning; Maria van Loon, Sjoukje van den Broek & Olle ten Cate.- PART III: Appendices
: Case 1: A 17-year old girl with a swelling in the neck; Case 2: A 68-year old man with swollen leg; Case 3: A 47-year old woman with fatigue; Case 4: Two patients with hearing loss.