Abstract:

Objective: Clinical reasoning is a necessary competence to make the right decision in clinical practice. In order to manage the cases, it is necessary to analyze the case, to determine the causes, to evaluate among those who are compatible with the case and to evaluate the results, to perform appropriate examinations and researches for the purpose, to interpret their results, to eventually exclude and calculate the probabilities, and to identify the diagnosis and solutions. In these processes, clinical reasoning and appropriate decisions are made. There is no consensus in case-based learning and evaluation, clinical reasoning definitions and methodologies, and practices are shaped according to the culture of educators and institutions. In the solution of the case, there is a need for a staged, easy-to-use and evaluation-appropriate model that focuses on clinical reasoning and decision making. Aim of the study, to introduce a case-based clinical reasoning and decision making model and evaluate its effectiveness. Material and Methods: University of Health Sciences Bakırköy. Sadi Konuk Training and Research Hospital, 13 students who received specialization training in the Urology Clinic, and 14 trainers responsible for their education in the Health Sciences University and Affiliated Training and Research Hospitals were included in the study. In post-graduate specialization training, students and educators were asked to apply the method after training on the introduction of the model and application methods. After the applications, an evaluation questionnaire about the usefulness of the model and perceptions of learning was conducted to the trainers and students. Results: The opinions of the educators and students about the model, the model is easily understood, it is easily applied in cases encountered in the clinic, it provides a systematic approach to the solution of the cases, it makes it easier to make differential diagnosis, it provides a versatile perspective, it reduces the possibility of making mistakes, it makes it possible to think about the reason when making decisions, and prevents unnecessary operations. found direction. The students stated that they could understand their knowledge about the model and increase their motivation to learn. The trainers have stated that preparation time for applying the model is more than other methods, students take responsibility for solving the case, the level of knowledge and deficiencies of the model and students are more easily understood, facilitating feedback and providing objectivity of the evaluation. Conclusions: If the case-based clinical reasoning and decision-making is made with the model that the educators and the students share, the possibility of malpractices, unnecessary examinations and interventions will be reduced, and the ability to make more conscious and evidence-based decisions will be increased.

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