Date of Award


Document Type


Degree Name

Master of Science (MS)



First Advisor

Yihsiang Chang


Clinical reasoning is a highly complex process that is both difficult to impart and acquire (Bowen 2006, Custers 2005, Merriënboer 2010, Schmidt 2015). Second year medical learners appear to lack strategy to effectively step through the presented scenarios (Allen, personal communication, March 2, 2015). Though possessing a degree of background knowledge, immature clinical reasoning skills make data collection (focused history, focused review of systems and focused physical assessments) a challenge to efficiently navigate. As oppose to discriminating their line of questions, learners sweep through a wide range of information. Consequently, problem solving takes on a shot gun approach resulting in a lack of intentionality. This study aims to understand the effects of exposing learners to a computer based instruction (CBI) of the clinical reasoning process prior simulation learning.

Instructional design techniques will be applied to understand the nature of the problem, derive a simulation performance assessment tool as well as to develop suitable computer based instruction. A repeated measurements study will be conducted to understand the effects of a computer based intervention on Second Year medical students' simulation learning. Data collected will include performance in simulation (pre and post intervention), performance within the computer based instruction and learner perception of the effectiveness of the CBI. A one way repeated measures ANOVA will be used to compare a performance before and after exposure to the intervention. The same test will also be used to understand differences between learners exposed to the intervention versus learners who chose not to utilize the instructional material. Finally, learner perception data will be used to determine how learners regard the CBI for simulation learning preparation.