IMPACT OF INTERACTIVE LEARNING APPROACHES ON THE DEVELOPMENT OF CLINICAL REASONING SKILLS AMONG UNDERGRADUATE MEDICAL STUDENTS
Main Article Content
Keywords
Clinical reasoning, Interactive learning, Medical education, Problem-based learning, Student engagement, Undergraduate students
Abstract
Background: Clinical reasoning is a fundamental competency in medical education, essential for accurate diagnosis and effective patient management. Traditional lecture-based teaching often limits students’ ability to apply theoretical knowledge to clinical situations. Interactive learning approaches, including problem-based learning, case-based discussions, and simulations, have been proposed to enhance analytical and reasoning skills among undergraduate medical students.
Objectives: To evaluate the impact of interactive learning approaches on the development of clinical reasoning skills among undergraduate medical students.
Study Design & Setting: A quasi-experimental study was conducted at the Department of Medical Education of Medical Education Foundation University Islamabad.
Methodology: A total of 170 undergraduate medical students were enrolled and randomly divided into two equal groups. Group A received interactive learning sessions, while Group B underwent traditional lecture-based instruction. Clinical reasoning skills were assessed before and after the intervention using a validated Clinical Reasoning Assessment Tool (CRAT). Data were analyzed using SPSS version 25.0, with p ≤ 0.05 considered statistically significant.
Results: The mean post-test score in the interactive learning group was significantly higher (78.62 ± 7.24) than in the traditional learning group (68.13 ± 6.91) (p < 0.001). Both groups showed improvement from pre- to post-test, but the gain was greater among students exposed to interactive strategies. Student satisfaction and engagement were also significantly higher in the interactive learning group.
Conclusion: Interactive learning approaches significantly enhance clinical reasoning skills, engagement, and satisfaction among undergraduate medical students compared to traditional methods.
References
2. Gonzalez L, Nielsen A, Lasater K. Developing students' clinical reasoning skills: A faculty guide. Journal of Nursing Education. 2021 Sep 1;60(9):485-93.
3. Perez-Perdomo A, Zabalegui A. Teaching strategies for developing clinical reasoning skills in nursing students: A systematic review of randomised controlled trials. InHealthcare 2023 Dec 30 (Vol. 12, No. 1, p. 90). MDPI.
4. Sim JJ, Rusli KD, Seah B, Levett-Jones T, Lau Y, Liaw SY. Virtual simulation to enhance clinical reasoning in nursing: a systematic review and meta-analysis. Clinical simulation in nursing. 2022 Aug 1;69:26-39.
5. Hosseinzadeh T, Tabrizi KN, Fallahi-Khoshknab M, Khankeh H, Shokooh F. Barriers to the development of clinical reasoning skills among coronary care nurses: a Qualitative Study. Iranian Journal of Nursing and Midwifery Research. 2022 Nov 1;27(6):567-74.
6. Bae J, Lee J, Choi M, Jang Y, Park CG, Lee YJ. Development of the clinical reasoning competency scale for nurses. BMC nursing. 2023 Apr 25;22(1):138.
7. Ahmed S, Shah H, Raza SZ. Evaluation of development of clinical reasoning skills in dental students through diagnostic thinking inventory. Journal of Pakistan Medical Association. 2023 Sep 30;73(9):1843-.
8. Mohammadi‐Shahboulaghi F, Khankeh H, HosseinZadeh T. Clinical reasoning in nursing students: A concept analysis. InNursing Forum 2021 Oct (Vol. 56, No. 4, pp. 1008-1014).
9. Alshehri FD, Jones S, Harrison D. The effectiveness of high-fidelity simulation on undergraduate nursing students' clinical reasoning-related skills: A systematic review. Nurse Education Today. 2023 Feb 1;121:105679.
10. Figueroa-Arce N, Figueroa-González P, Gómez-Miranda L, Gutiérrez-Arias R, Contreras-Pizarro V. Implementation of an Objective structured clinical examination (OSCE) as a tool to evaluate the development of clinical reasoning in physical therapy students. Revista de la Facultad de Medicina. 2022 Jun;70(2).
11. Firman DR, Ezzat NA, Bustraan J, de Beaufort AJ, Diewerke A. Authentic learning environments for critical thinking and clinical reasoning skills in clinical pharmacology: a scoping review. European Journal of Pharmacology. 2025 Sep 8:178124.
12. Brentnall J, Thackray D, Judd B. Evaluating the clinical reasoning of student health professionals in placement and simulation settings: A systematic review. International Journal of Environmental Research and Public Health. 2022 Jan 14;19(2):936.
13. Leite AS, Alves VD, Félix TL, Marinho CC. Clinical cases created by Medical students in the development of clinical reasoning: a systematic review. Revista Brasileira de Educação Médica. 2025;49(3).
14. de Sá Tinôco JD, Cossi MS, Fernandes MI, Paiva AC, de Oliveira Lopes MV, de Carvalho Lira AL. Effect of educational intervention on clinical reasoning skills in nursing: a quasi-experimental study. Nurse Education Today. 2021 Oct 1;105:105027.
15. Mwale OG, Mukwato PK, Kabinga-Makukula M. Acquisition of clinical reasoning skills by undergraduate nursing students in Malawi; towards the development of a middle-range theory: a qualitative study. BMC nursing. 2025 Apr 14;24(1):416.
16. Rehan R, Farooqi L, Khan H, Rehman R. Comparison of two interactive tutorial methods: results from a medical college in Karachi. JPMA. The Journal of the Pakistan Medical Association. 2017;67(2):196.
17. Fatima M, Khan A, Naz R, Noori MY. Impact of Teaching Methods on Clinical Reasoning in Forensic Medicine: A Quasi-Experimental Study. Medical Education. 2024 Sep.
18. McGee RG, Wark S, Mwangi F, Drovandi A, Alele F, Malau-Aduli BS, ACHIEVE Collaboration. Digital learning of clinical skills and its impact on medical students’ academic performance: a systematic review. BMC Medical Education. 2024 Dec 18;24(1):1477.
19. Muqeem A, Arshad S, Sajid S, Ahmad A. Skills and attitudes of students which affect fostering of critical thinking in undergraduate medical students. Pak. Armed Forces Med. J.. 2022 Oct 1;72(5):1711-5.
20. Abdullah Z, Khan M, Asfandyar A, Aman K, Asim B, Haris S. Impact of Team-Based Learning on Medical Students Academic Performance: Team-Based Learning on Academic Performance of Medical Students. Pakistan Journal of Health Sciences. 2025 Jan 31:203-8.
