Teaching clinical reasoning skills using an online team-based learning method.

Publication date: Jul 18, 2026

Clinical reasoning is a complex skill that requires a healthcare professional to apply clinical judgment, expertise, and reasoning, along with foundational knowledge, to solve complex problems in uncertain situations. This study evaluated the effectiveness of teaching Clinical Reasoning Skills (CRS) through an online Team-Based Learning (TBL) approach, using scores from a Script Concordance Test (SCT) as the main outcome measure. This quasi-experimental study was carried out at the Orthopedic Department of Khyber Teaching Hospital, Peshawar, Pakistan, from January to June 2021. Postgraduate orthopedic residents (PGRs) meeting the inclusion criteria were selected. The study involved several steps. First, the PGRs prepared for the TBL sessions. Then, students completed 20 SCT items with three questions each (pretest). Due to the coronavirus pandemic, an online TBL session was conducted. Afterwards, students completed another set of 20 SCT items with three questions each (post-test). A paired t-test was used to compare the pre- and post-intervention scores. The mean test score of SCT increased from 32. 50 (pre-test) to 37. 81 after the TBL (P = 0. 023). We analyzed the data and divided it into quartiles to identify the upper and lower quartiles. Additionally, performers in the bottom quartile in the pre-test had a mean score of 21. 38, which rose to 35. 13 (P = 0. 027) after the test. Students’ responses to SCT were enhanced by teaching via an online TBL approach. Online TBL is an effective method for teaching clinical reasoning skills to postgraduate residents in Orthopedics postgraduate training.

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