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Related Experiment Video

Updated: Jun 27, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
14:32

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Published on: February 16, 2011

'Place' and clinical reasoning development in context: An ethnographic case study.

Sisira Dharmaratne1,2, Asela Olupeliyawa3, Kam Cheong Wong4,5

  • 1Translational Health Research Institute, Western Sydney University, Australia.

Medical Teacher
|June 25, 2026
PubMed
Summary
This summary is machine-generated.

Place-Based Medical Education (PBME) uniquely shapes clinical reasoning (CR) development in medical students. Understanding how specific locations influence physician training enhances preparedness for underserved communities.

Keywords:
General PracticePlace-based medical educationlongitudinal integrated clerkshipsparallel consultingsense-of-place

Related Experiment Videos

Last Updated: Jun 27, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
14:32

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Published on: February 16, 2011

Area of Science:

  • Medical Education
  • Clinical Reasoning
  • Sociology of Health

Background:

  • Place-Based Medical Education (PBME) aims to train physicians for underserved areas, but the role of 'place' is conceptual.
  • Previous research highlighted a lack of empirical evidence on how place features influence Clinical Reasoning (CR) development.
  • The HARD framework was proposed to guide research on place and CR.

Purpose of the Study:

  • To empirically investigate how distinct features of place impact the development of clinical reasoning in medical students.
  • To build upon the HARD framework by examining the influence of context on CR.
  • To explore the relationship between CR development, sense-of-place, place-dependence, and place-identity.

Main Methods:

  • An ethnographic case study was conducted in General Practice (GP) settings.
  • Data collection included 120 hours of participant observation, 57 interviews, and analysis of curriculum documents and artefacts.
  • Thematic analysis of the rich data set was informed by the HARD model and a 'sense-of-place' interpretive lens.

Main Results:

  • Five domains of CR development were identified, with each student exhibiting a unique, placement-influenced pathway.
  • Empirical evidence demonstrated how CR development in context shapes place-dependence and place-identity.
  • CR development was found to be cognitive, relational, and socio-material.

Conclusions:

  • Findings align with the HARD conceptualisation, emphasizing CR development as a multifaceted process.
  • This transtheoretical perspective enhances understanding of place distinctiveness in medical training.
  • Attention to context is crucial for designing and delivering effective physician training in PBME settings and beyond.