Chinese Journal of Medical Education ›› 2025, Vol. 45 ›› Issue (5): 338-343.DOI: 10.3760/cma.j.cn115259-20241114-01180

• Postgraduate Medical Education • Previous Articles     Next Articles

Clinical thinking cultivation in standardized residency training

Lan Xueli1, Xiang Yang2   

  1. 1Department of Respiratory and Critical Care Medicine, Aerospace Central Hospital & Clinical School of Astronautics, Peking University, Beijing 100049, China;
    2Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
  • Online:2025-05-01 Published:2025-04-29
  • Contact: Xiang Yang, Email: xiangy@fudan.edu.cn
  • Supported by:
    Beijing Municipal Health Commission 2023 Resident Doctor Standardized Training Quality Improvement Project (2023012)

Abstract: This paper integrates the principles of cognitive psychology and pedagogy into the teaching of clinical thinking, exploring the theoretical foundation, strategies, instructing elements and methods for cultivating clinical thinking during standardized training for resident doctors. The theoretical foundations of clinical thinking teaching include: Dual Process Theory, Metacognition Theory, and Constructivism. The teaching strategies for clinical thinking include: student-centered learning philosophy, spiral progression teaching model, debriefing and feedback in clinical thinking, and reflection-based metacognitive adjustment. The instructing elements encompass establishing a conceptual framework, enhancing information-gathering skills, developing diagnostic reasoning abilities, fostering diagnostic demonstration and verification capabilities, as well as promoting decision-making proficiency in diagnosis and treatment. By utilizing teaching rounds, case discussions, medical record writing and revision sessions along with Mini-clinical evaluation exercises (mini-CEX), this paper elucidates the aims, strategies employed in different educational activities related to residents′ clinical thinking training, while highlighting key aspects and potential challenges. Furthermore, attention is drawn to evaluating clinical thinking abilities effectively in instructional practices while stimulating residents′ intellectual potential; acknowledging the value inherent in traditional teaching approaches; as well as comprehending the essence of thoughtful instruction.

Key words: Standardized residency training, Clinical thinking training, Dual process theory, Metacognition theory, Constructivism, Bedside teaching

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