[Structured training of physicians in clinical reasoning and decision-making has a positive impact on the quality of care].

Abstract

Explicit training in clinical reasoning and rational decision-making improves the quality of diagnostic judgments, patient safety, and the ethical dimension of decisions by strengthening metacognition, enriching illness scripts built from clinical practice, and incorporating patients' values. To be effective, it should rely on a longitudinal curriculum, active strategies (deliberate practice, SNAPPS+, one-minute preceptor, test-enhanced learning), and a climate of cognitive safety. The challenge is to structure such teaching within clinical environments under heavy time pressure, workload and patient turn-over, with unpredictable teaching opportunities, limited institutional recognition, and large, heterogeneous groups of learners.