Twelve tips for implementing deliberate reflection in clinical reasoning education.

IF 4 2区教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Medical Teacher Pub Date : 2026-09-22 DOI:10.1080/0142159X.2026.2733150

Francisco Carlos Specian Junior, Henk G Schmidt, Dario Cecilio-Fernandes

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引用次数: 0

Abstract

Diagnostic reasoning is fundamental to safe clinical practice, yet it is often taught through unstructured case discussions that provide limited support for the development of diagnostic expertise. Deliberate reflection is a structured educational strategy supported by more than 15 years of experimental research demonstrating its effectiveness in improving diagnostic reasoning by promoting the refinement of illness scripts, reducing cognitive biases, and supporting learning. However, despite this growing body of evidence, educators still lack concise, evidence informed guidance on how to implement deliberate reflection across different educational contexts. Drawing on the accumulated experimental evidence and recent advances in clinical reasoning education, this article provides twelve practical tips to support the implementation of deliberate reflection. Organised around key implementation decisions, including selecting appropriate learners, choosing reflection formats, matching case complexity to learner expertise, calibrating instructional guidance, promoting transfer, integrating deliberate reflection throughout the curriculum, and preserving its core cognitive principles, these recommendations translate current evidence into a practical guidance.

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在临床推理教学中实施深思熟虑的12个要点。

诊断推理是安全临床实践的基础，但它往往是通过非结构化的案例讨论来教授的，这对诊断专业知识的发展提供了有限的支持。刻意反思是一种结构化的教育策略，有超过15年的实验研究支持，证明了它通过促进疾病脚本的细化、减少认知偏见和支持学习来提高诊断推理的有效性。然而，尽管有越来越多的证据，教育工作者仍然缺乏关于如何在不同教育背景下实施深思熟虑的指导。根据积累的实验证据和临床推理教育的最新进展，本文提供了十二个实用提示，以支持刻意反思的实施。这些建议围绕关键的实施决策进行组织，包括选择合适的学习者、选择反思形式、将案例复杂性与学习者的专业知识相匹配、校准教学指导、促进迁移、在整个课程中整合深思熟虑的反思，以及保留其核心认知原则，这些建议将当前的证据转化为实践指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Teacher 医学-卫生保健

CiteScore

7.80

自引率

8.50%

发文量

396

审稿时长

3-6 weeks

期刊介绍： Medical Teacher provides accounts of new teaching methods, guidance on structuring courses and assessing achievement, and serves as a forum for communication between medical teachers and those involved in general education. In particular, the journal recognizes the problems teachers have in keeping up-to-date with the developments in educational methods that lead to more effective teaching and learning at a time when the content of the curriculum—from medical procedures to policy changes in health care provision—is also changing. The journal features reports of innovation and research in medical education, case studies, survey articles, practical guidelines, reviews of current literature and book reviews. All articles are peer reviewed.