title: The association between student characteristics and the development of clinical reasoning in a graduate-entry, PBL medical programme.
abstract: This study sought to assess the extent to which the entry characteristics of students in a graduate-entry medical programme predict the subsequent development of clinical reasoning ability. Subjects comprised 290 students voluntarily recruited from three successive cohorts of the University of Queensland's MBBS Programme. Clinical reasoning was measured once a year over a period of three years using two methods, a set of 10 Clinical Reasoning Problems (CRPs) and the Diagnostic Thinking Inventory (DTI). Data on gender, age at entry into the programme, nature of primary degree, scores on selection criteria (written examination plus interview) and academic performance in the first two years of the programme were recorded for each student, and their association with clinical reasoning skill analysed using univariate and multivariate analysis. Univariate analysis indicated significant associations between CRP score, gender and primary degree with a significant but small association between DTI and interview score. Stage of progression through the programme was also an important predictor of performance on both indicators. Subsequent multivariate analysis suggested that female gender is a positive predictor of CRP score independently of the nature of a subject's primary degree and stage of progression through the programme, although these latter two variables are interdependent. Positive predictors of clinical reasoning skill are stage of progression through the MBBS programme, female gender and interview score. Although the nature of a student's primary degree is important in the early years of the programme, evidence suggests that by graduation differences between students' clinical reasoning skill due to this factor have been resolved.
authors.affiliation: Faculty of Biological and Chemical Sciences, University of Queensland, St Lucia, 4072, Australia. m.groves@uq.edu.au
authors.forename: Michele
authors.initials: M
authors.lastname: Groves
authors.forename: Peter
authors.initials: P
authors.lastname: O'rourke
authors.forename: Heather
authors.initials: H
authors.lastname: Alexander
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D015331:Cohort Studies; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000592:standards*; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic / Q000592:standards; D016014:Linear Models; D008128:Logic; D008297:Male; D011237:Predictive Value of Tests; D011340:Problem Solving; D018794:Problem-Based Learning / Q000592:standards*; D011793:Queensland; D012570:School Admission Criteria / Q000706:statistics & numerical data; D012737:Sex Factors; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013997:Time Factors