PBL and Dual Process Reasoning Sonoma State University faculty applied the work of Durham et al XXXXXXXXXXby using problem-based learning (PBL) cases that used the hypothetico-deductive and...

PBL and Dual Process Reasoning

Sonoma State University faculty applied the work of Durham et al. (2014) by using problem-based learning (PBL) cases that used the hypothetico-deductive and nonanalytical reasoning processes. Clinical case scenarios were presented to the students, and, with the assistance of the faculty, the students worked through each case. The faculty interaction during the case presentation also encouraged pattern recognition (a nonanalytical process) so reinforcing the dual-process model of diagnostic reasoning. Three cases were used that followed different paths. The clinical scenarios depicted various age groups and an increasing degree of complexity. The cases were presented as a chief complaint or symptom, and the students were asked to then interview the patient. The faculty encouraged the students to consider differential diagnoses early in the presentation of the case. The cases encouraged the students to consider all diagnoses, and, through the process, they were able to narrow down the possibilities and reach a most likely diagnosis. As the cases unfolded, further data gathering and clinical reasoning occurred, reinforcing the dual process of diagnostic reasoning. Students were positive about this approach to learning diagnostic reasoning. This process demonstrated a shift from the nursing model to the dualprocess approach to diagnostic reasoning used by other healthcare professionals. This is important as transitioning from a nurse, where the diagnosis is known, to that of an NP, whose job is to diagnose, requires the development of expert diagnostic skills.