title: Clinical reasoning sessions: back to the patient.
abstract: BACKGROUND
  Problem-based learning (PBL) was developed as a facilitated small group learning process based around a clinical problem. Originally designed for pre-clinical years of medical education, its application across all years poses a number of difficulties, including the risk of reducing patient contact, providing a learning process that is skewed towards an understanding of pathophysiological processes, which may not be well understood in all areas of medicine, and failing to provide exposure to clinically relevant reasoning skills.
  
  
  BACKGROUND
  Curriculum review identified dissatisfaction with PBLs in the clinical years of the Sydney Medical School's Graduate Medical Program, from both staff and students. A new model was designed and implemented in the Psychiatry and Addiction Medicine rotation, and is currently being evaluated.
  
  
  METHODS
  We describe an innovative model of small-group, student-generated, case-based learning in psychiatry - clinical reasoning sessions (CRS) - led by expert facilitators.
  
  
  CONCLUSIONS
  The CRS format returns the student to the patient, emphasises clinical assessment skills and considers treatment in the real-world context of the patient. Students practise a more sophisticated reasoning process with real patients modelled upon that of their expert tutor. This has increased student engagement compared with the previous PBL programme.
authors.affiliation: Discipline of Psychiatry & Westmead Clinical School, Sydney Medical School, University of Sydney, Australia. anthony.harris@sydney.edu.au
authors.forename: Anthony
authors.initials: A
authors.lastname: Harris
authors.forename: Phillip
authors.initials: P
authors.lastname: Boyce
authors.forename: Rola
authors.initials: R
authors.lastname: Ajjawi
mesh_terms: D001315:Australia; D016739:Behavior, Addictive; D003479:Curriculum; D004059:Diffusion of Innovation; D004504:Education, Medical, Undergraduate / Q000379:methods; D005246:Feedback; D006126:Group Processes; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017145:Models, Educational; D018794:Problem-Based Learning / Q000379:methods*; D011570:Psychiatry / Q000193:education*; D018570:Risk Assessment / Q000379:methods; D013337:Students, Medical; D011795:Surveys and Questionnaires; D013663:Teaching