Online patient simulation training to improve clinical reasoning: a feasibility randomised controlled trial

BMC Medical Education

Table 3 Mean scores and correlations between measures of clinical reasoning, knowledge and diagnostic choice

Reasoning measure	Group^a	N	Mean Scores (SD)	Correlation coefficients
Reasoning measure	Group^a	N	Mean Scores (SD)	Self-reported clinical reasoning at baseline^b		Knowledge at baseline^c		Diagnostic choice^d
Self-reported clinical reasoning skills				r_s^e	p	r_s	p	r_s	p
Baseline	I	122	83.1 (9.6)			0.17	0.057	−0.01	0.927
	C	118	83.5 (8.8)			0.10	0.270	0.09	0.463
	All	240	83.3 (9.2)			0.14	0.037*	0.04	0.663
Time 1^f	I	99	84.1 (10.3)
	C	86	82.4 (9.0)
	All	185	83.3 (9.8)
Time 2^g	I	75	84.4 (9.8)
	C	65	82.0 (9.4)
	All	140	83.3 (9.7)
Observed clinical reasoning skills^h
Essential information identifiedⁱ	I	78	61.6% (17.6)	−0.01	0.957	0.09	0.423	0.09	0.435
	C	70	53.3% (15.8)	0.03	0.798	0.22	0.074	0.13	0.303
	All	148	57.7% (17.2)	0.01	0.865	0.15	0.78	0.12	0.144
Relevance of history taking^j	I	78	81.4% (10.5)	0.06	0.578	0.06	0.623	0.12	0.304
	C	70	84.6% (10.6)	0.02	0.893	0.11	0.356	0.08	0.518
	All	148	82.9% (10.6)	0.03	0.704	0.07	0.415	0.10	0.251
Flexibility in diagnoses^k	I	78	3.2 (1.0)	0.01	0.919	0.17	0.137	0.01	0.933
	C	70	3.0 (1.0)	0.09	0.439	0.04	0.772	0.23	0.054
	All	148	3.1 (1.0)	0.05	0.542	0.11	0.186	0.12	0.137

^aIntervention (I) and Control group (C)
^bMeasured using the Flexibility in Thinking scale (Bordage et al. 1990)
^cMeasured by 12 multiple choice respiratory medicine questions
^dMeasured by whether the most important diagnosis was selected for a patient case
^er_s denotes Spearman’s rank correlation coefficient
^fTime 1 = one week after registration
^gTime 2 = one month registration
^hMeasured by performance on a patient case delivered by eCREST to all students
ⁱPercentage of essential information from gathered from patient case out of possible essential information available
^jPercentage of relevant information from gathered from patient case out of all information student gathered
^kNumber of times changed diagnosis
* indicates p ≤ 0.05

ISSN: 1472-6920