A model of learning clinical reasoning at a US-based workshop: interactive reasoning

Area of Science:

• Medical Education
• Clinical Reasoning
• Cross-cultural Healthcare Education

Background:

• University of Hawaii School of Medicine has offered a 5-day clinical reasoning workshop for Japanese medical students since 2001.
• The workshop aims to facilitate the learning of clinical reasoning in a US-based educational setting.

Purpose of the Study:

• To investigate the learning process of clinical reasoning among Japanese medical students in a US educational workshop.
• To understand how students adapt to and acquire new reasoning skills in an international context.

Main Methods:

• Qualitative study employing 20 semi-structured interviews with students.
• Non-participant observation and analysis of 40 standardized-patient encounters via videotapes.

Main Results:

• Students initially faced linguistic and cultural challenges but successfully acquired medical interviewing skills.
• Clinical reasoning was understood as a process involving patient rapport-building to gather information for differential diagnosis and hypothesis testing.
• A model of Interactive Reasoning was supported by the findings.

Conclusions:

• Foreign medical students can surmount linguistic and cultural barriers in US-based workshops.
• The study demonstrates successful acquisition of medical interviewing and clinical reasoning skills by international students.