Table 1
Summary of Case Reviews.
| LEVEL OF TRAINING | NEW CASE | FOLLOW-UP CASE | TOTAL |
|---|---|---|---|
| PGY*–1 | 4 | 8 | 12 |
| PGY-2 | 5 | 10 | 15 |
| PGY-3 | 1 | 11 | 12 |
| PGY-4 | 3 | 9 | 12 |
| PGY-5 | 1 | 1 | 2 |
| Total | 14 | 39 | 53 |
[i] *PGY: Post-Graduate Year.
Table 2
Reasoning Tasks Addressed During Case Reviews.
| REASONING TASK17 | NEWb (JUNIOR) (na = 10) | NEW (SENIOR) (n = 4) | FOLLOW-UPc (JUNIOR) (n = 29) | FOLLOW-UP (SENIOR) (n = 10) | TOTAL (n = 53) |
|---|---|---|---|---|---|
| A. Identify Active Issues | 9 (90%) (Cases 3, 7, 9, 11, 19, 20, 35, 44, 48) | 3 (75%) (Cases 36, 37, 53) | 24 (83%) (Cases 1, 2, 5, 8, 12, 13, 14, 21, 22, 24, 25, 26, 29, 31, 32, 33, 34, 39, 40, 41, 42, 43, 45, 51) | 8 (80%)_ (Cases 6, 10, 15, 16, 17, 23, 38, 47) | 44 (83%) |
| A1. Assess Priorities | 2 (20%) (Cases 7, 11) | 1 (25%) (Case 37) | 2 (69%) (Case 18, 31) | 2 (20%) (Cases 10, 38) | 7 (13%) |
| A2. Reprioritize Based on Assessment | 3 (30%) (Cases 7, 9, 11) | 0 (0%) | 2 (69%) (Cases 13, 14) | 0 (0%) | 5 (94%) |
| A3. Consider And Prioritize Diagnosis Including Most Likely Diagnosis and Most Serious Diagnosis to Rule Out | 9 (90%) (Cases 3, 7, 9, 11, 20, 35, 44, 48, 52) | 3 (75%) (Cases 27, 36, 37) | 15 (52%) (Cases 1, 5, 8, 13, 21, 22, 29, 32, 33, 39, 40, 41, 42, 43, 51) | 4 (40%) (Cases 6, 38, 46, 47) | 31 (59%) |
| A4. Identify Precipitants or Triggers to The Current Problem(s) | 3 (30%) (Cases 19, 35, 44) | 1 (25%) (Case 37) | 3 (10%) (Cases 13, 33, 40) | 0 (0%) | 7 (13%) |
| A5. Select Diagnostic Investigations Taking into Account Goals of Care | 6 (60%) (Cases 9, 19, 20, 35, 44, 48) | 3 (75%) (Cases 27, 36, 37) | 10 (34%) (Cases 13, 21, 22, 31, 33, 40, 41, 42, 43, 51) | 4 (40%) (Cases 6, 10, 15, 17) | 23 (43%) |
| B. Determine Most Likely Diagnosis with Underlying Cause(s) | 8 (80%) (Cases 3, 7, 9, 11, 19, 20, 35, 52) | 3 (75%) (Cases 27, 36, 37) | 14 (48%) (Cases 13, 14, 18, 21, 22, 31, 32, 33, 34, 39, 40, 41, 43, 50) | 4 (40%) (Cases 6, 17, 30, 38) | 29 (55%) |
| B1. Identify Modifiable and Non-Modifiable Risk Factors | 7 (70%) (Cases 3, 7, 9, 11, 19, 20, 35) | 0 (0%) | 3 (10%) (Cases 24, 31, 33) | 2 (20%) (Cases 6, 15) | 12 (23%) |
| B2. Identify Complications Associated with Diagnosis, Diagnostic Investigations, or Treatment | 6 (60%) (Cases 3, 9, 19, 20, 35, 44) | 1 (25%) (Cases 37) | 17 (59%) (Cases 1, 5, 8, 13, 14, 24, 31, 32, 33, 34, 39, 40, 41, 42, 43, 49, 51) | 4 (40%) (Cases 10, 15, 30, 38) | 28 (53%) |
| B3. Assess Rate of Progression, Response to Treatment and Estimate Prognosis and Length of Stay | 4 (40%) (Cases 35, 44, 48, 52) | 2 (50%) (Cases 36, 37) | 19 (66%) (Cases 1, 2, 8, 13, 14, 24, 26, 28, 29, 32, 33, 34, 39, 40, 41, 42, 43, 45, 50) | 7 (70%) (Cases 10, 15, 16, 17, 30, 38, 47) | 32 (60%) |
| B4. Explore Physical and Psychosocial Consequences of Current Medical Conditions or Treatment | 6 (60%) (Cases 3, 7, 35, 44, 48, 52) | 0 (0%) | 7 (24%) (Cases 2, 12, 13, 14, 33, 40, 41) | 0 (0%) | 13 (25%) |
| B5. Establish Goals of Care | 0 (0%) | 0 (0%) | 7 (24%) (Cases 13, 14, 18, 21, 32, 34, 50) | 0 (0%) | 7 (13%) |
| B6. Explore Interplay of Psychosocial Context and Management | 3 (30%) (Cases 3, 35, 44) | 2 (50%) (Cases 27, 36) | 2 (7%) (Cases 18, 31) | 0 (0%) | 7 (13%) |
| B7. Consider Impact of Comorbid Illness on Management | 1 (10%) (Case 20) | 1 (25%) (Case 27) | 4 (14%) (Cases 18, 39, 41, 49) | 1 (10%) (Case 10) | 7 (13%) |
| B8. Consider the Consequences of Management on Comorbid Illnesses | 0 (0%) | 0 (0%) | 3 (10%) (Cases 18, 25, 51) | 1 (10%) (Case 16) | 4 (8%) |
| B9. Consider Alternative Treatment Options | 2 (20%) (Cases 20, 48) | 2 (50%) (Cases 27, 53) | 9 (31%) (Cases 2, 12, 13, 18, 21, 25, 32, 34, 49) | 1 (10%) (Case 16) | 14 (26%) |
| B10. Consider Implications of Available Resources on Diagnostic or Management Choices | 1 (10%) (Case 52) | 0 (0%) | 1 (3%) (Case 29) | 1 (10%) (Case 38) | 3 (6%) |
| C. Establish Management Plan | 8 (80%) (Cases 3, 7, 9, 11, 35, 44, 48, 52) | 2 (50%) (Cases 36, 37) | 24 (83%) (Cases 1, 2, 4, 8, 12, 13, 14, 21, 24, 25, 26, 28, 29, 31, 32, 33, 34, 39, 40, 41, 42, 43, 49, 50) | 9 (90%) (Cases 6, 10, 15, 16, 17, 23, 30, 38, 46) | 43 (81%) |
| C1. Select Education and Counselling Approach for Patient and Family | 1 (10%) (Case 52) | 1 (25%) (Case 53) | 7 (24%) (Cases 2, 12, 13, 14, 21, 24, 50) | 1 (10%) (Case 47) | 10 (19%) |
| C2. Explore Collaborative Roles for Patient and Family | 0 (0%) | 0 (0%) | 1 (3%) (Case 34) | 0 (0%) | 1 (2%) |
| C3. Determine Follow-Up and Consultation Strategies | 3 (30%) (Cases 3, 44, 48) | 2 (50%) (Case 27, 36) | 12 (41%) (Cases 1, 2, 8, 13, 14, 31, 33, 34, 39, 49, 50, 51) | 9 (90%) (Cases 6, 10, 15, 17, 23, 30, 38, 46, 47) | 26 (49%) |
| C4. Determine What to Document and Who Should Receive Documentation | 3 (30%) (Cases 7, 44, 52) | 1 (10%) (Case 27) | 2 (7%) (Cases 50, 51) | 1 (10%) (Case 38) | 7 (13%) |
| C5. Assess Severity | 7 (70%) (Case 3, 11, 19, 20, 35, 44, 48) | 1 (10%) (Case 37) | 18 (62%) (Cases 1, 2, 5, 8, 12, 18, 24, 29, 31, 32, 33, 39, 40, 41, 42, 45, 49, 50) | 6 (60%) (Cases 10, 17, 23, 30, 38, 47) | 32 (60%) |
| C6. Assess Decision-Making Capacity | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
[i] an = number of case reviews that addressed that specific reasoning task.
bNew Consultation.
cFollow-Up Visit.
Legend: Table 2 summarizes the results of the template analysis. The “Reasoning Task” column presents the previously developed reasoning tasks [^17], with the three overarching categories shown in bold and labeled A–C, followed by their corresponding sub-tasks listed alpha-numerically. The next columns indicate the total number of new and follow-up cases, further divided by junior and senior residents. Case review numbers (1–53) identify which reviews addressed each reasoning task, followed by the total count (n) and percentage (%) of case reviews in which that task appeared.