title: A model of learning clinical reasoning at a US-based workshop: interactive reasoning.
abstract: BACKGROUND
  Since 2001 the University of Hawaii School of Medicine has conducted a 5-day workshop on clinical reasoning for Japanese medical students. To determine how Japanese medical students learn clinical reasoning at a US-based educational workshop.
  
  
  METHODS
  This qualitative study used 20 semi-structured interviews with students, non-participant observation, and videotapes of 40 standardized-patient encounters.
  
  
  RESULTS
  Participants initially struggled with linguistic and cultural differences, then acquired an understanding of medical interviewing. Students understood clinical reasoning as a process of connecting with the patient using rapport building in order to gather information necessary to form a differential diagnosis and test hypotheses in conjunction with the physical examination. These findings supported a model of Interactive Reasoning.
  
  
  CONCLUSIONS
  Our findings suggest that foreign medical students can overcome linguistic and cultural barriers at a US-based workshop and acquire an understanding of medical interviewing and clinical reasoning.
authors.affiliation: University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA. bts-tky@umin.ac.jp
authors.forename: Brian Taylor
authors.initials: BT
authors.lastname: Slingsby
authors.forename: Seiji
authors.initials: S
authors.lastname: Yamada
authors.forename: Gordon
authors.initials: G
authors.lastname: Greene
mesh_terms: D003226:Congresses as Topic; D018864:Cultural Diversity; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007858:Learning; D008037:Linguistics; D008297:Male; D017145:Models, Educational; D010817:Physician-Patient Relations; D011340:Problem Solving; D014481:United States; D055815:Young Adult