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Title: Teaching clinical reasoning through hypothetico-deduction is (slightly) better than self-explanation in tutorial groups : an experimental study
Authors: Donmez, Mustafa
Mamede, Silvia
Schmidt, Henk G.
Ahmed Al Rumayyan
Nasr Ahmed
Reem Al Subait
Ghassan Al Ghamdi
Moeber Mohammed Mahzari
Tarig Awad Mohamed
Rotgans, Jerome Ingmar
Keywords: Clinical Teaching
Clinical Reasoning
Issue Date: 2018
Source: Ahmed Al Rumayyan, Nasr Ahmed, Reem Al Subait, Ghassan Al Ghamdi, Moeber Mohammed Mahzari, Tarig Awad Mohamed, . . . Schmidt, H. G. (2018). Teaching clinical reasoning through hypothetico-deduction is (slightly) better than self-explanation in tutorial groups : an experimental study. Perspectives on Medical Education, 7(2), 93-99. doi:10.1007/s40037-018-0409-x
Series/Report no.: Perspectives on Medical Education
Abstract: Background: Self-explanation while individually diagnosing clinical cases has proved to be an effective instructional approach for teaching clinical reasoning. The present study compared the effects on diagnostic performance of self-explanation in small groups with the more commonly used hypothetico-deductive approach. Methods: Second-year students from a six-year medical school in Saudi Arabia (39 males; 49 females) worked in small groups on seven clinical vignettes (four criterion cases representing cardiovascular diseases and three ‘fillers’, i.e. cases of other unrelated diagnoses). The students followed different approaches to work on each case depending on the experimental condition to which they had been randomly assigned. Under the self-explanation condition, students provided a diagnosis and a suitable pathophysiological explanation for the clinical findings whereas in the hypothetico-deduction condition students hypothesized about plausible diagnoses for signs and symptoms that were presented sequentially. One week later, all students diagnosed eight vignettes, four of which represented cardiovascular diseases. A mean diagnostic accuracy score (range: 0–1) was computed for the criterion cases. One-way ANOVA with experimental condition as between-subjects factor was performed on the mean diagnostic accuracy scores. Results: Students in the hypothetico-deduction condition outperformed those in the self-explanation condition (mean = 0.22, standard deviation = 0.14, mean = 0.17; standard deviation = 0.12; F(1, 88) = 4.90, p= 0.03, partial η2= 0.06, respectively). Conclusions: Students in the hypothetico-deduction condition performed slightly better on a follow-up test involving similar cases, possibly because they were allowed to formulate more than one hypothesis per case during the learning phase.
ISSN: 2212-2761
DOI: 10.1007/s40037-018-0409-x
Rights: © 2018 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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