Reflecting on Exchanged Students' Learning: Bedside Demonstration, Case Reporting and Clinical Reasoning

Abstract

Background: The increasing opportunities for medical students to participate in international, supervised and structured electives have been shown in our recent study, which enhanced students’ professionalism, cultural competence and clinical reasoning skills in preclinical years. However, evidence is scant in achieving the specific learning objectives and improving clinical reasoning during clinical years. This study aims to demonstrate how the short-term supervised elective can improve students’ clinical reasoning skills, skills of case report writing and satisfactory academic performance.Results: We recorded daily discussions on the demonstrated skills and cases collection with six Curtin Medical School students from Australia during a 19-day supervised elective at the First Affiliated hospital, Sun Yat-sen University, China. The daily clinical reasoning discussions, case collection and bedside demonstrations in different disciplines became the main content of the reflections discussed in this article. Their feedback was recorded post-elective to examine the impact of the exchange in their ongoing case report writing, clinical reasoning skills development and academic performance. The main themes of case-based clinical reasoning identified in the daily discussions and feedbacks were described by the students in two frameworks. Learning through clinical reasoning is well demonstrated during students-supervisors daily debrief. The students have used these clinical reasoning skills in their ensuing clinical placement with satisfactory academic performances. The students have completed two case reports individually with cases for publication in both Australian Doctor and BMJ case report. The supervisors obtained students’ feedbacks at the time of the elective, 6-month and 12-month post-elective, and feedback summary is highlighted in three aspects including improved clinical reasoning skills, scientific writing skills and satisfactory academic performance.Conclusions: These reflections provide insight into how this exchange elective may improve students’ clinical reasoning, enhance scientific writing skills and strengthen academic performance.