Anand Jagannath Profile picture
Clinician-educator at @OHSUSOM @OHSUIMRes. Thinking about how to teach reasoning #DxEd #TeachDx

May 3, 2022, 10 tweets

#Medtwitter, last week I posted about a talk I gave on teaching #clinicalreasoning

As promised, the accompanying #tweetorial

Come explore with me!
1/10

I described a gap between DOING and TEACHING reasoning

All of us DO reasoning every day

TEACHING what we DO is hard unless we
✔️have vocabulary to describe it
✔️know how to describe a process
✔️are ok being vulnerable in front of others
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How do we make an invisible process (reasoning), visible?

Step 1: use specific words to describe steps to the cognitive process:

Problem representation
Schema
Illness scripts

Speaking these words signals their importance to your learners - use them!
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Step 2: engage in a Cognitive Apprenticeship

An evolution of the traditional apprenticeship, CA emphasizes narrated thinking in many forms to develop reasoning skills

Not unique to medicine, but applicable

Many techniques within CA - these 3 are money
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Applied to teaching reasoning:

💥Thinking aloud shows how reasoning happens
💥Coaching lets you observe and give real-time feedback
💥Reflection helps build plans for improvement

🎩@jackpenner for teaching me🙏🌹

💡more on CA: pubmed.ncbi.nlm.nih.gov/25800294/
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Step 3: Intellectual Streaking!!

Drs. Bearman and Molloy teach that I.S. is the way we expose uncertainty to our learners to model growth

@LiangRhea made me aware of this term 🙏🌹
@CPSolvers builds their culture around it ("I don't know!")❤️
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Becoming comfortable with being UNcomfortable is how we go from projecting our uncertainty on our learners to showing learners how WE find and fill our gaps in knowledge and reasoning
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The gap between DOING and TEACHING reasoning is understandably large, but by remembering that reasoning is a process, we can take steps to define, shrink, and even bridge that gap
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Taking a page from @gradydoctor's book, so much gratitude for these humans for giving me opportunity and trust, role-modeling excellence, and teaching me new things. You are all gems 🙏🌹❤️
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For more, including inspiration behind the title and some worked examples, I'm happy to give the full version of this talk in-person or remotely!

Thank you, #Medtwitter!
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