Context and setting We studied the expression of clinical reasoning of internal medicine senior residents and interns during case presentations in the out-patient setting. Compared with interns, we hypothesised that senior residents would present more efficiently and express more clinical reasoning during case presentations. We rated the level of thinking expressed by preceptors (teaching staff) and learners in patient case discussions using the 3-point Preceptor Thinking Promotion Scale and corresponding Learner Thinking-Behaviour Scale to identify whether conversations occur at the level of: (i) giving the facts of the case; (ii) explaining assessment or decisions, or (iii) exploring uncertainties or difficulties.
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