What are the expectations for a longitudinal clinical reasoning curriculum? An international needs analysis by the DID-ACT project

ABSTRACT:Background: Clinical reasoning is an indispensable skill integral to the practice of all health professions. Deficiencies in its acquisition and maintenance lead to an increased rate of medical errors that is a major challenge faced by healthcare systems worldwide. Yet, training clinical reasoning skills is challenging because of the complex and tacit nature of experts’ performance and controversies regarding how to best teach this skill in learners.Summary of Work: DID -ACT is a three-year project co-funded by the Erasmus+ programme of the European Union in years 2020-2022 involving eight international partner institutions. The project aims to develop, implement and disseminate an adaptive clinical reasoning curriculum for healthcare students and educators. Guided by David Kerns six-step approach to curriculum development, we completed a general needs assessment that was implemented as a web survey distributed to all AMEE members. This is followed by a specific needs assessment to deepen the analysis.Summary of Results: The 313 respondents of the international web survey highlighted a great need for a longitudinal clinical reasoning curriculum. The presence of such a curriculum was reported by 28% of respondents and the need for such stated by 85%. A gap was identified in terms of clinical reasoning teaching strategies and cognitive error avoidance. The most outstanding barriers were lack of awareness of the need for explicit clinical reasoning teaching, lack of guidelines for curriculum development and lack of qualified faculty.Discussion and Conclusions: The general needs analysis provided data to better understand the state of clinical reasoning curricula at the global level. The specific needs assessment that follows in the project is conducted at partner institutions and includes semi-structured interviews, focus groups and additional questionnaire that will have finished in June 2020. The outcomes of the DID-ACT project are available at the project’s website (www.did-act.eu). Take -home Messages: There is a considerable interest of the health professions educators community in a longitudinal explicit clinical reasoning curriculum. The awareness of assessment procedures and teaching strategies needs to be increased on the overarching international level.