Introduction: This study explores tutors’ experience of teaching diagnostic reasoning (DR) – a key component of clinical reasoning – to build understanding into the use of explicit strategies in facilitating development of DR skills in preclinical medical students.

Methods: A qualitative, interpretive study was undertaken with 14 preclinical problem-based learning tutors who participated in semi-structured interviews. A thematic analysis was conducted to identify key factors that influence students’ learning of diagnostic reasoning.

Results: Tutor dispositions towards facilitating learning of DR were variable in this study. Explicit strategies to teach DR were thought to exert positive influences on the development of DR skills, through improving student knowledge and reducing potential error. The advantages of using explicit strategies to teach DR outweighed the perceived difficulties identified in this context. Explicit strategies may need modification for preclinical students and the focus should be on building knowledge of classic presentations and developing metacognitive awareness.

Conclusion: The use of explicit educational strategies will contribute to facilitating preclinical student learning of DR skills. Tutor professional development is a key component in the successful implementation of these strategies.


clinical reasoning, tutor development, educational strategies, preclinical

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