Learning clinical reasoning in gastroenterology

Teaching clinical reasoning remains a major challenge in medical training. We conducted a descriptive, cross-sectional and evaluative before-and-after study of seven DCEM2 students in a gastroenterology internship at the Tunis Faculty of Medicine (February-March 2025). Three Clinical Reasoning Learning (CRL) sessions were organized on: complicated bulbar ulcer, dysphagia and ascites of decompensated cirrhosis. Each session included a pre- and post-test (10 True/False questions), followed by a Likert-type satisfaction questionnaire. Results showed a progressive average cognitive gain (2.6; 2.9; 3.2/20) and high student satisfaction (>70% for knowledge consolidation, 100% for improved reasoning). The CRA encouraged participation, motivation and interactivity, while structuring diagnostic reasoning. Despite its limitations (small size, cognitive-only assessment), ARC appears to be a relevant teaching method for reinforcing clinical learning in gastroenterology, and deserves to be developed on a larger scale.