Twelve Tips for Developing Clinical Reasoning Skills in the Pre-Clinical and Clinical Stages of Medical School

Abstract

Clinical reasoning (CR) is a complex skill required in future clinicians. The best way to develop CR has not been fully elucidated in existing literature. Barriers to CR development include content, environmental, and teacher or expert physician factors. We have reviewed literature, interviewed medical students and teaching staff at the University of Nottingham, and evaluated our teaching delivery. We identified twelve strategies to combat barriers to CR learning at our university. The foundation for CR must be built early through lectures and case-based learning. We emphasize the irreplaceable nature of ward-based learning and add on methods of optimizing time on wards. Placement on acute wards with trained teaching staff to facilitate CR teaching was suggested. Ward time should be supplemented with symptom-focused teaching, patient workshops, simulation sessions, virtual case banks, and clinical skills practice. However, ward time is the utmost priority and must not be replaced.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Notes on contributors

Dr Swe Khin-Htun, MBBS, MRCS, MMedSCi (Medical Education), MAcdMEd, MFST, PhD student, is currently a Medical Education Fellow, Nottingham University Hospitals NHS Trust, Honorary Assistant Professor, School of Medicine, University of Nottingham. Her research interests focus on clinical reasoning.

Anisa Kushairi, BMedSci, is a final year medical student at the University of Nottingham with an interest in medical education.