Table 2 Additional quotations

Q1

I think that [clinical reasoning] encompasses using your current knowledge in tackling new patients, of new […] uhm […] findings that you encounter. Using that knowledge, you reason what it could be. Because you do not have the experience yet to know what it is, but you do have enough experience to know what it could be and how you could find out.

Q3

Yes, I have noticed growth. Especially the past year, during my clinical clerkships. At the beginning I did all the clinical reasoning steps separately. Just like you mentioned, now I’m connecting the steps more. At this point, I’m working on compiling management plans myself and at the next clerkship I want to get more involved in the evaluation, so that I have carried out all aspects of the process. So it’s more about having performed all aspects and doing everything in sequence rather than separately. That’s where I’ve grown. And I’m also doing it more efficiently and in a more targeted manner. At first I found it difficult to see the wood from the trees. But that has become a lot better and I am able to frame things better.

Q4

[…]Yeah, then I’ll have the feeling, like ‘I have a responsibility because I’m sitting in a room with this person. I can make this experience a positive or a negative one, purely by how I’m behaving.’ So if you look at it like that, you really have the responsibility, in my opinion. You’re not responsible for the whole medical side of things, but you are for how this patient is feeling at this moment and how he’s experiencing his visit. And I think that […] because of that I’m really motivated to make the most of it. To really immerse myself in their disease, so I won’t miss anything. So that I […] Yeah because you just want what’s best for them or something.

Q5

At Internal Medicine, it was like, people were thinking ‘Okay, but what else could it be, let’s think, what’s there? What do we need to know to figure out exactly what it is?’ In Neurology and Psychiatry, and even more so at the Surgery department, it’s more like ‘This is it and we’re going to act on this.’

Q6

[…] In Neurology, they would mostly be checking whether it was a neurological problem or not. And if it wasn’t that, it was more or less over immediately.[…] I do find that very difficult when a department says ‘Yes it’s something, we don’t know what exactly, but it’s not something our department should be dealing with, so you have to go somewhere else.[…]

Q10

Yes and then you can tell if […] uhm […] ‘Well, was this something I could have thought of myself? Am I lagging behind everyone else?’

Q11

And, of course, it’s true that two know more than one, right? So, you might notice that you’re stuck at something because you don’t have enough knowledge of a subject. And then someone who’s sitting next to you knows about different things, so you can get […] then you can work together and still move forward.