Enhancing clinical reasoning skills in medical students through team-based learning: a mixed-methods study

作者：Kosuke Ishizuka, Kiyoshi Shikino, Naoko Takada, Y Sakai, Yasushi Ototake, Takashi Kobayashi, Tetsuhiko Inoue, Ryosuke Jikuya, Yuri Iwata, Kenichi Nishimura, Ryusuke Yoshimi, Yasufumi Oi, Yuko Watanabe, Yu Togashi, Fumihiro Ogawa, Daisuke Sano, Takeshi Asami, Yuichi Imai, Ichiro Takeuchi, Kengo Funakoshi, Mitsuyasu Ohta, Masahiko Inamori, Akihiko Kusakabe · 发表于：BMC Medical Education · 年份：2025 · DOI：10.1186/s12909-025-06784-w · 被引用次数：15 · 研究领域：Clinical Reasoning and Diagnostic Skills、Problem and Project Based Learning、Innovations in Medical Education

BACKGROUND: Clinical reasoning skills are essential competencies for medical students; therefore, effective, evidence-informed teaching methodologies are needed worldwide. This study investigated the benefits of team-based learning (TBL) for developing the skills in medical students. METHOD: A mixed-methods sequential explanatory design was used to investigate the effectiveness of TBL for medical students acquiring clinical reasoning skills. The study participants comprised 92 fourth-year medical students at Yokohama City University School of Medicine, participating in TBL sessions that covered 10 major clinical symptoms identified in the core curriculum. Each session lasted 240 min. Before and after the educational intervention, student performance was measured using the script concordance test (SCT) on a 30-point scale, and self-assessed clinical reasoning competency was measured on a 7-point Likert scale. The SCT included pre-tests and post-tests of 30 questions each, with students randomly assigned to one of two test sets. Following the quantitative evaluation, a qualitative content analysis was conducted to explore the advantages of TBL for learning clinical reasoning skills. The analytic categories were set according to the six levels of Fink's taxonomy of significant learning. RESULT: Student performance improved significantly after the educational intervention (A test: 16.5 ± 4.4 to 18.7 ± 4.5, p = 0.019; B test: 18.1 ± 3.7 to 19.8 ± 4.4, p = 0.028). After the educati...