Wu, BianWang, MinhongJohnson, Janice M.Grotzer, Tina2015-02-022014Wu, Bian, Minhong Wang, Janice M. Johnson, and Tina A. Grotzer. 2014. “Improving the learning of clinical reasoning through computer-based cognitive representation.” Medical Education Online 19 (1): 10.3402/meo.v19.25940. doi:10.3402/meo.v19.25940. http://dx.doi.org/10.3402/meo.v19.25940.1087-2981http://nrs.harvard.edu/urn-3:HUL.InstRepos:13890667Objective: Clinical reasoning is usually taught using a problem-solving approach, which is widely adopted in medical education. However, learning through problem solving is difficult as a result of the contextualization and dynamic aspects of actual problems. Moreover, knowledge acquired from problem-solving practice tends to be inert and fragmented. This study proposed a computer-based cognitive representation approach that externalizes and facilitates the complex processes in learning clinical reasoning. The approach is operationalized in a computer-based cognitive representation tool that involves argument mapping to externalize the problem-solving process and concept mapping to reveal the knowledge constructed from the problems. Methods: Twenty-nine Year 3 or higher students from a medical school in east China participated in the study. Participants used the proposed approach implemented in an e-learning system to complete four learning cases in 4 weeks on an individual basis. For each case, students interacted with the problem to capture critical data, generate and justify hypotheses, make a diagnosis, recall relevant knowledge, and update their conceptual understanding of the problem domain. Meanwhile, students used the computer-based cognitive representation tool to articulate and represent the key elements and their interactions in the learning process. Results: A significant improvement was found in students’ learning products from the beginning to the end of the study, consistent with students’ report of close-to-moderate progress in developing problem-solving and knowledge-construction abilities. No significant differences were found between the pretest and posttest scores with the 4-week period. The cognitive representation approach was found to provide more formative assessment. Conclusions: The computer-based cognitive representation approach improved the learning of clinical reasoning in both problem solving and knowledge construction.en-USclinical reasoningproblem solvingknowledge constructioncognitive representationcomputers/technologyJournal Article2015-02-0210.3402/meo.v19.25940