title: Developing clinical reasoning in the classroom - analysis of the 4C/ID-model.
abstract: OBJECTIVE
  The purpose of this study is to provide a theoretical rationale for the implementation of the four-component instructional design model for complex learning (4C/ID-model) at the University of Pretoria with the aim of systematically developing the clinical reasoning of undergraduate dental students in a classroom setting.
  
  
  METHODS
  Recent literature provides a rationale for the use of the 4C/ID-model to teach clinical reasoning in terms of four strategic teaching and learning needs: (i) the need for authenticity in the learning process; (ii) the need to manage cognitive load during the learning process; (iii) the need for repeated practice; (iv) a need for valid assessment, feedback and reflection.
  
  
  CONCLUSIONS
  The literature review indicated that the 4C/ID-model makes provision for teaching and learning in an authentic context and proposes systematically structured methods that could be practically applied to manage cognitive load during repetitive exercises. The model also makes provision for cognitive feedback following assessment in order to eliminate misconceptions about content and to develop the cognitive strategies of the learner.
  
  
  CONCLUSIONS
  On the basis of the literature review above, it is recommended that the 4C/ID-model be considered as a basis for classroom teaching and learning to develop competence in clinical reasoning in undergraduate dental students, even at pre-clinical level. The model may also have an application in medical education.
authors.affiliation: Department of Dental Management Sciences, School of Dentistry, University of Pretoria, Pretoria, South Africa.
authors.forename: T C
authors.initials: TC
authors.lastname: Postma
authors.forename: J G
authors.initials: JG
authors.lastname: White
mesh_terms: D000328:Adult; D004497:Education, Dental / Q000379:methods*; D004521:Educational Measurement; D006801:Humans; D007858:Learning; D017145:Models, Educational; D013850:Thinking
keywords: authenticity; clinical reasoning; cognitive load; repetition; teaching and learning