title: Using illness scripts to teach clinical reasoning skills to medical students.
abstract: OBJECTIVE
  Most medical students learn clinical reasoning skills informally during clinical rotations that have varying quality of supervision. We conducted a randomized controlled trial to determine if a workshop that uses "illness scripts" could improve students' clinical reasoning skills when making diagnoses of patients portrayed in written scenarios.
  
  
  METHODS
  In 2007--2008, 53 fourth-year medical students were randomly assigned to either a family medicine (intervention) or psychiatry (control) clerkship at The Chinese University of Hong Kong. Students in the intervention group participated in a 3-hour workshop on clinical reasoning that used illness scripts. The workshop was conducted with small-group teaching using a Web-based set of clinical reasoning problems, individualized feedback, and demonstration of tutors' reasoning aloud. The effectiveness of the intervention was assessed using the Diagnostic Thinking Inventory (DTI) and the measurement of individual students' performance in solving clinical reasoning problems (CRP).
  
  
  RESULTS
  The post-intervention overall DTI scores between groups were similar (mean difference 0, 95% confidence interval [CI]= -7.4 to 7.4). However, the total scores on the CRP assessment were 14% (95% CI=8% to 21%) higher in the intervention group than in controls.
  
  
  CONCLUSIONS
  A workshop on illness scripts may have some benefit for improving diagnostic performance in clinical reasoning problems.
authors.affiliation: Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China. annalee@cuhk.edu.hk
authors.forename: Anna
authors.initials: A
authors.lastname: Lee
authors.forename: Gavin M
authors.initials: GM
authors.lastname: Joynt
authors.forename: Alex K T
authors.initials: AK
authors.lastname: Lee
authors.forename: Anthony M H
authors.initials: AM
authors.lastname: Ho
authors.forename: Michele
authors.initials: M
authors.lastname: Groves
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Vlantis
authors.forename: Ronald C W
authors.initials: RC
authors.lastname: Ma
authors.forename: Colman S C
authors.initials: CS
authors.lastname: Fung
authors.forename: Cindy S T
authors.initials: CS
authors.lastname: Aun
mesh_terms: D002983:Clinical Competence; D004501:Education, Medical / Q000379:methods*; D005194:Family Practice; D005260:Female; D006801:Humans; D007360:Intelligence; D011340:Problem Solving / Q000502:physiology*; D011570:Psychiatry; D013337:Students, Medical; D013663:Teaching / Q000379:methods*