Teaching and learning clinical reasoning: tutors' perceptions of change in their own clinical practice.

Background: Clinical reasoning is an important skill for all clinicians and historically has rarely been formally taught either at undergraduate or postgraduate level. Clinical reasoning is taught as a formal course in the fourth year of the undergraduate programme at Keele School of Medicine by tutors who are all practicing general practitioners.

Aim: We aimed to explore the tutors' perceptions about how teaching on the course has impacted on their own consultation skills.

Design And Setting: All 11 course tutors who had taught on the course for at least one full academic year were invited to take part in recorded individual semi-structured interviews with an experienced, non-clinical, qualitative researcher. The data were analysed using qualitative methods.

Results: Eleven tutors participated, with a range of 7 to 32 years of clinical experience. They reported better decision-making, greater use of metacognition, more self-awareness, more reflective practice, more confidence and greater job satisfaction. They also reported positive impacts on their own knowledge and learning, and assumed concomitant benefits for their patients.

Conclusion: All clinicians in this group perceived benefits on their consultation skills as a result of teaching clinical reasoning. There is a need to provide education, training and continuing professional development in cognitive consultation skills to students, trainees and established practitioners.