The impact of deliberate reflection with WISE-MD™ modules on surgical clerkship students’ critical thinking: a prospective, randomized controlled pilot study

Janet Fraser Hale,1 Jill M Terrien,1 Mark Quirk,2 Kate Sullivan,2 Mitchell Cahan3 1Graduate School of Nursing, University of Massachusetts Medical School, Worcester, MA, USA; 2Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, USA; 3Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA Purpose: Critical thinking underlies several Association of American Medical Colleges (AAMC)-defined core entrustable professional activities (EPAs). Critical-thinking ability affects health care quality and safety. Tested tools to teach, assess, improve, and nurture good critical-thinking skills are needed. This prospective randomized controlled pilot study evaluated the addition of deliberate reflection (DR), guidance with Web Initiative in Surgical Education (WISE-MD™) modules, to promote surgical clerks’ critical-thinking ability. The goal was to promote the application of reflective awareness principles to enhance learning outcomes and critical thinking about the module content.Participants and methods: Surgical clerkship (SC) students were recruited from two different blocks and randomly assigned to a control or intervention group. The intervention group was asked to record responses using a DR guide as they viewed two selected WISE-MD™ modules while the control group was asked to view two modules recording free thought. We hypothesized that the intervention group would show a significantly greater pre- to postintervention increase in critical-thinking ability than students in the control group.Results: Neither group showed a difference in pre- and posttest free-thought critical-thinking outcomes; however, the intervention group verbalized more thoughtful clinical reasoning during the intervention.Conclusion: Despite an unsupported hypothesis, this study provides a forum for discussion in medical education. It took a sponsored tool in surgical education (WISE