Assessing the efficacy of a case-based clinical reasoning workshop for medical students: a randomized controlled trial

Abstract

Background Clinical reasoning is a core competency in medical education, yet many undergraduate medical students struggle to develop flexible diagnostic thinking and well-organized knowledge structures. Case-based learning has been suggested as an effective approach to support the development of these skills. Objective This study evaluated the effect of a case-based clinical reasoning workshop on medical students’ diagnostic thinking, focusing on flexibility of thinking, memory structure, and performance on a case-specific differential diagnosis task. Methods A randomized controlled educational trial was conducted at Shiraz University of Medical Sciences involving 51 fourth-year medical students. Participants were randomly assigned to an intervention group that received a 6-hour case-based clinical reasoning workshop or to a control group that continued the standard curriculum. Outcomes were assessed before and after the intervention using the Diagnostic Thinking Inventory (DTI) and a customized differential diagnosis test. Results The intervention group showed significant improvements in DTI flexibility of thinking and memory structure compared with the control group. Both groups improved on the differential diagnosis test, but the between-group difference was not statistically significant. Conclusions A brief case-based clinical reasoning workshop led to improvements in general diagnostic thinking among undergraduate medical students.