Blended learning framework to teach clinical reasoning

A framework underpinned by cognitive load theory and collaborative team based learning to teach clinical reasoning skills.

Underpinned by an innovative flipped learning model, ensures that both the online content and the classroom activities are based on the same pedagogical principles and cognitive psychology.

The online content is specifically designed to introduce new concepts through a series of worked examples that allow the student to process the information through decision making tasks, clinical reasoning and observations.

The relevant science is described in context to support understanding of the condition being presented.  Cases feature a video demonstration of patient symptoms or presenting complaint to provide authenticity to the scenario.  The clinical reasoning required to explain symptoms and signs, order and interpret investigations and start management is demonstrated as the case develops.

The inclusion of authentic learning tasks, guided instruction and supportive information will assist in knowledge acquisition and the transfer of learning to new contexts.

Students complete scenario based assessments to determine readiness for group discussion.

Students are equipped to attend the face to face activity with:
•       a good understanding of the relevant basic science and patient presentation
•       basics in clinical reasoning and decision making.

The format of the group discussion has been designed as an interactive case based discussion, drawing upon elements of the online case, but providing different contexts to enable students to apply and practice their clinical reasoning skills to new patient scenarios. The format is structured to ensure small group collaboration around authentic patient tasks.


blended learning and assessment framework

In Summary

Preparation phase – readiness to attend classroom activity – worked examples/reflection/assessment – to determine knowledge level

(instructional strategies – visual design, multimedia design, interaction design (reduce cognitive load)

Case based scenarios using worked examples – showing clinical thinking processes of expert clinician

  • 3 example cases – reference to different systems

Collaborative team based learning phase

  • Initial testing
  • Scenarios – group collaboration
  • Reflection with resident/registrar facilitator

Workplace phase

  • Application to clinical work setting
  • Collection of patient stories
  • Supervisor assessment

Post activity phase

  1. Reflection in action
  2. At point of care guidelines – summary from prep docs/learning points from f2f
  3. Practical tips to suppor future clinical practice

Program evaluation

  • Supervisor perception
  • Revision of content and teaching strategy to inform quality improvement process