Student experiences of learning clinical reasoning

Summary Background Students find learning clinical reasoning skills challenging. Viewing how students learn clinical reasoning skills from a sociocultural perspective, however, may allow helpful and unhelpful descriptions to be interpreted as experiences that promote or inhibit their participation in and opportunities to co‐construct their clinical reasoning skills. Methods This interview study was conducted with 25 Year‐6 undergraduate medical students. Interview data were first analysed thematically, and then the findings were analysed with the concepts of participation and co‐construction. Results The themes identified were: (1) practising with undifferentiated patients; (2) teachers who were willing to make thinking explicit; (3) a lack of independence and involvement; (4) a lack of communication and feedback; and (5) confusion from different sources of information. When further analysed, the themes could be represented as points along a continuum of participating in, and co‐constructing, clinical reasoning skills. Discussion Clinical educators will find the themes identified from students’ experiences learning in a workplace environment helpful for understanding why some students may struggle to develop their clinical reasoning skills. An interpretation of findings from a sociocultural perspective offers a different approach for understanding students’ difficulties when learning clinical reasoning: one where students are able to increase their participation in, and co‐construction of, clinical reasoning in the context of working collaboratively to provide patient care. Students find learning clinical reasoning skills challenging