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Journal article
How and When Should Clinical Reasoning Be Taught in Undergraduate Medicine: A Systematic Review and Meta-Analyses
Perspectives on Medical Education, Vol.14(1), pp.1021-1042
2025
PMID: 41488570
Abstract
Background: Clinical reasoning is a critical aspect of clinical practice, though there is considerable variation regarding how and when to teach this skill. This systematic review and meta-analyses examined the effectiveness of interventions that explicitly taught clinical reasoning in undergraduate medical education and the optimal timing for introducing interventions.
Methods: A systematic (PRISMA 2020) search of the SCOPUS, MEDLINE, CINAHL, PsycINFO, ERIC, and Informit databases was conducted from 1 January 2014 to 31 December 2024. The quality of studies was assessed using the Quality Assessment with Diverse Studies tool. Pooled estimates and 95% confidence intervals (CIs) were estimated using both random and fixed effects meta-analyses.
Results: The final sample included 50 studies, of which 46 (92%) reported a measurable improvement. Small-group teaching generally achieved better outcomes, with technology and serious game innovations further improving them. Meta-analysis of six randomised control trials using a random effects model showed an overall significant result (MD 2.23; 95% CI: 0.67, 3.80; I2 = 88%). A subgroup analysis indicated that interventions undertaken in pre-clinical years (MD 0.32; 95% CI: –3.99, 4.64; I2 = 88%) did not result in significant improvements, whereas interventions in the clinical years were significant (MD 1.89; 95% CI: 1.06, 2.72; I2 = 88%). A second subgroup analysis showed that interventions based on face-to-face workshops (MD 1.74; CI: 1.19, 2.28; I2 = 88%) were significant.
Conclusions: The findings suggest that small-group activities, such as interactive online modules, may lay a foundation for early-year students, while skills-based workshops and serious games progressively refine and enhance clinical reasoning. Future research should focus on longitudinal outcomes and standardised assessment measures across diverse educational contexts.
Details
- Title
- How and When Should Clinical Reasoning Be Taught in Undergraduate Medicine: A Systematic Review and Meta-Analyses
- Authors
- Stuart Wark (Corresponding Author) - University of New EnglandAaron Drovandi - University of ManchesterRichard G McGee - University of Newcastle AustraliaFaith O Alele - University of the Sunshine Coast, Queensland, School of Health - Public HealthFelista Mwangi - University of Newcastle AustraliaBunmi Malau-Aduli - University of Newcastle AustraliaACHIEVE network
- Publication details
- Perspectives on Medical Education, Vol.14(1), pp.1021-1042
- Publisher
- Ubiquity Press Ltd.
- Date published
- 2025
- DOI
- 10.5334/pme.1986
- ISSN
- 2212-277X; 2212-2761
- PMID
- 41488570
- Copyright note
- © 2025 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.
- Data Availability
- All data generated for this review and meta-analysis is referred to within the main body of the document.
- Organisation Unit
- School of Health - Public Health
- Language
- English
- Record Identifier
- 991201648202621
- Output Type
- Journal article
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