Raisonnement clinique des médecins et autres professionnels de la santé

Aims

1. Clinical reasoning: how does it works and how to train and supervise it?
   - provide a framework for supervising clinical reasoning. Make links between theory and practice to support clinical teachers’ work.
2. Learners with academic difficulties and more specifically  Clinical reasoning difficulties
   - identify potential academic and/or clinical reasoning difficulties as they may occur in the clinical context, and propose specific remediation strategies
3. Clinical Reasoning and multimorbidity
   - Understand and promote clinical reasoning in chronic and multimorbid conditions
4. Collaborative reasoning.
   - contribution of interprofessional team members to clinical reasoning and decisions in internal medicine urgent situations

Persons involved :

UDREM-UNIGE Marie-Claude Audétat Mathieu Nendaz Julia Sader Matteo Coen

Collaborations nationales UIGP-UNIGE Claire Ritz Hubert Maisonneuve Sarah Cairo Notari HUG/CIS Katherine Blondon

Collaborations internationales Université de Montréal Nathalie Caire Fon, Bernard Charlin, Suzanne Laurin Université de Laval Miriam Lacasse Université de Sherbrooke Elisabeth Boileau Christina St-Onge Université de Strasbourg Thierry Pelaccia McGill University Valérie Dory

 

Supported by :

• Fonds G3 2017 (partenariat entre les Universités de Genève, Bruxelles et Montréal)
• University of Geneva Faculty of medicine, Fonds MIMOSA 2017
• SGAIM Foundation :Appel à projet 2016-17
• Fondation Ernst et Lucie Schmidheiny (ME 8676) and the Projet de Recherche et de Développement, Hôpitaux Universitaires de Genève (PRD 2010-II-5).

REsults :

Thème 1: Clinical reasoning: how does it works and how to train and supervise it?

Research Question: How can clinical teachers support clinical reasoning?

• Overview of the literature on clinical reasoning and practical tips to facilitate its development

https://archive-ouverte.unige.ch/unige:103148

• This guide, written in French, aims to provide readers with a framework for supervising clinical reasoning

https://archive-ouverte.unige.ch/unige:110181

• This book chapter presents in French the main supervision tools and strategies

https://archive-ouverte.unige.ch/unige:114927

Research Question: What is the state of research on clinical reasoning in Emergency Departments?

• Scoping review:

https://archive-ouverte.unige.ch/unige:123602

Research Question: What is the role of illness scripts in guiding clinical reasoning during clinical encounters?

• This essay provides a basic sketch of script theory, and proposes strategies for aligning teaching practices in the classroom and the clinical setting with the basic principles of script theory.

https://archive-ouverte.unige.ch/unige:86166

 

Thème 2: Learners with academic difficulties and more specifically Clinical reasoning difficulties

Research Question: Is there a way for clinical teachers to assist struggling learners?

• This systematic review identifies interventions for undergraduate and postgraduate medical learners experiencing academic difficulties and provides literature-based recommendations.

https://archive-ouverte.unige.ch/unige:118012

• This synthetic review of the literature presents the empirical evidence and theory that may guide clinical teachers in their daily task of supervising struggling learners, reviewing current knowledge on the challenges and solutions that have been identified and explored.

https://archive-ouverte.unige.ch/unige:92569

• This book chapter presents in French a framework to help trainees in difficulty

https://archive-ouverte.unige.ch/unige:114926

Research Question: How can clinical teachers diagnose potential clinical reasoning difficulties and help trainees?

• This Guide describes the educational process of supporting clinical reasoning and diagnosing potential clinical reasoning difficulties. The focus is on the management of these difficulties, providing a more detailed description and specific remediation strategies.

https://archive-ouverte.unige.ch/unige:103148

• This paper provides a detailed overview of the main difficulties in clinical reasoning, including the cues to look out for in clinical supervision, the root causes of each difficulty and targeted remediation strategies.

https://archive-ouverte.unige.ch/unige:97057

• This guide, written in French, aims to provide readers with a framework for identifying and supervising clinical reasoning difficulties

https://archive-ouverte.unige.ch/unige:110177

• This research evaluates the relevance of a mobile application to help clinical teachers verify and describe clinical reasoning difficulties

https://archive-ouverte.unige.ch/unige:118110

• This book chapter in French is intended for students and presents the main difficulties in clinical reasoning. It aims to develop a reflective approach on its own clinical reasoning.

https://archive-ouverte.unige.ch/unige:101659

 

Thème 3: Clinical Reasoning and multimorbidity

Research Question: Is clinical reasoning different when doctors and healthcare professionals take care of patients suffering of chronic and multimorbid conditions?

• This paper explore the ways in which clinical reasoning processes are involved in the follow up of patients suffering from multimorbidities. A better understanding of these clinical processes will enrich supervision of trainees and collaboration between healthcare professionals.

https://www.scirp.org/Journal/paperinformation.aspx?paperid=95759

 

Thème 4. Collaborative reasoning.

Are role perceptions of residents and nurses translated into action?

• https://bmcmededuc.biomedcentral.com/track/pdf/10.1186/s12909-017-0976-2?site=bmcmededuc.biomedcentral.com

• A concordance-based study to assess doctors' and nurses' mental models in Internal Medicine

http://dx.plos.org/10.1371/journal.pone.0182608