Medical students

ABSTRACT Clinical reasoning skills are considered as essential domain needed to be acquired to become a good physician The Diagnostic Thinking Inventory (DTI) is a tool used for measuring critical thinking skills namely flexibility in thinking and evidence for Structure in memory. To measure the clinical reasoning skills among medical students in Alzaiem Alazhari University.. It is cross-section study which was conducted at the Faculty of Medicine, Alzaiem Alazhari University (AAU) Khartoum,to measure clinical reasoning skills using the diagnostic thinking inventory(DTI) of 5th(92),9th(63) semester & the newly graduate (62) a total of 181students . The study population (74%) were under graduate (in 5th&9th.Semester), while the remainder were newly graduate (26%),all were scored high levels .Tests of correlation, for the 3 subgroups, for DTI scores the flexibility of thinking & Structure of Knowledge and the standard of Bordage, Grant & Marsden in 1990 (81.6& 87.4) for the students in 5th. Semester were 0.004 &0.000 for the 9th Semester students were, 0.001 & 0.000while for the newly graduate students were 0.424&,0.003 which were significant at P>0.05 using one sample t test &Nonparametric test ( Wilcoxon Signed Rank Test) was used when the data distribution was not normal. The correlation, for the 3 subgroups using one-way ANOVA was not significant (0.893& 0.680). DTI is an appropriate instrument for a comparative survey of self-assessed clinical reasoning among students at different semesters. The curriculum of AAU faculty of medicine is integrating basic and clinical sciences in solving community, family and individual health problems according to known methods of problem solving. In addition started teaching clinical reasoning skills earlier so, DTI scores were found to be high in all subgroups 5th, 9th & the newly graduate. There is Conclusive evidence that critical thinking skills and abilities can be taught, so medical curriculum should be integrated & based in problem based learning so as to graduate student with Critical thinking & good clinical reasoning skills. Keywords: Clinical reasoning skills,, Medical students, DTI, Curriculum

The objective of this study was to assess the perception, skills and comfort level of medical students in clinical years regarding breaking bad news and perceived attainment of objectives in communication skills module. This is a survey using quasi-experimental (pre- /post-intervention) study design. All students in the final year at OMC, consented to participate were included in the study. Questionnaires were provided prior and post-workshop. The commonly used 6-point SPIKES protocol for breaking bad news was discussed. Questionnaire was mainly comprised of demographic details, pre and post ques¬tions, any previous training in communication skills, whether they had observed bad news being broken by a senior, how stressful they thought BBN was to them and SPIKES protocol, confidence levels among participants in communicating bad new and barriers of breaking bad news. Statistical analysis was performed using SPSS 20.v. Data were expressed in frequencies, mean and percent¬ages, t test and man Whitney U test were used to evaluate the significant differences between pre and post responses. A total of 70 medical students were participated in the study in which 60 (85.7%) were female participants. Significant statistical difference was observed between pre and post response of participants involving communicating bad news (p - 0.025). Similarly, there was a significant difference in the responses of participants aged <25 and ≥ 25 years responses regarding communicating bad news (p < 0.001). This study results revealed that at pre workshop, participants had statistically significantly (p-0.006, 95% CI -15.08-2.63) low pre-workshop score compared to post-workshop responses. Similarly, statistical difference was observed between age > 25 and <25 years old participants (p-0.027, 95% CI -1.19-19.13). No significant difference was found between male and female participant’s responses (p-0. 927, 95% CI -9.03-8.22).