Journal of general internal medicine
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Many medical schools have incorporated clinical reasoning (CR) courses into their pre-clinical curricula to address the quality and safety issue of diagnostic error. It is unknown how students use concepts and practices from pre-clinical CR courses once in clerkships. ⋯ Concepts taught in a pre-clinical CR course influenced how students prepared for and navigated clinical encounters. Contextual factors both enhanced and inhibited the utilization of CR concepts. Our findings align with social learning theories including social cognitive theory and ecological psychology. This contextual view-taking into account interactions between personal, social, and environmental factors-can help educators integrate CR education from the classroom to the clinical setting.