Teaching Clinical Reasoning in Nephrology: Theory, Practice, and Educational Evaluation
Hanène Gaied *
Mongi Slim Hospital, Tunis, Tunisia.
Sonia Ben Nasr
The Military Hospital in Tunis, Tunisia.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Clinical Reasoning Learning (CRL) sessions enable students to engage in contextualised, student-centred learning activities.
Aim: This study aimed to assess the immediate educational impact of three CRL sessions on nephrology trainees.
Study Design: A pre- and post-evaluation study was conducted.
Study Location and Date: The Nephrology Department at Mongi Slim Hospital.
Methodology: The study involved 24 students divided into three groups during three different internship periods across the 2023/2024 and 2024/2025 academic years. Each group participated in three CRL sessions, each lasting 60 minutes. These sessions focused on the theme of “raised creatinine.” The immediate pedagogical effectiveness was evaluated based on cognitive gains, measured using a knowledge questionnaire administered before (pre-test) and after (post-test) each CRL session, and student satisfaction, assessed using an opinion questionnaire. Results: The CRL sessions were conducted interactively in accordance with the pre-established scenario.
Results: The median student score was 10.25/20 points [2.75-15] at the pre-test, compared with 11.75/20 points [6-16.75] at the post-test. The average pre-test score across the three CRL sessions was 9.48/20, while the average post-test score was 11.95/20. Overall, 18 students improved their scores, and the mean score increased by 2.47 points. All students either agreed or strongly agreed that the session timing was appropriate, that the sessions were interactive, that they better understood the course material, that they better understood the diagnostic process, and that these sessions were an effective learning method.
Conclusion: The findings suggest that CRL sessions may be a valuable educational tool for learning clinical reasoning during tutorial sessions organised within clinical internships. However, successful implementation also requires concurrent investment in the pedagogical training of teaching staff.
Keywords: Learning clinical reasoning, nephrology, learning, clinical internship, pedagogy