Clinical reasoning in the context of a computer-based learning environment

The acquisition of diagnostical competencies is an important goal of medical education. Computer- and case-based learning systems frequently have been used as a possibility to foster the development of diagnostical competencies in addition to bedside- teaching. The research on clinical reasoning, however, focusses on the processes and strategies of experts and neglects the processes of development of such competencies. Especially, computer- and case-based environments can be used as a tool for research on such learning and development processes. This approach allows the analysis of the generative construction of the hypotheses from first clues to the final diagnosis. Two very different courses of clinical reasoning of students give insight to problems which are typical for novices and intermediates.