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  • Open Access
  • © 2018

Principles and Practice of Case-based Clinical Reasoning Education

A Method for Preclinical Students


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  • Is an easily accessible overview of the backgrounds and history of clinical reasoning education

  • Covers approaches to the assessment of clinical reasoning ability

  • Describes a method that can be applied in any medical school

  • Aligns with current thinking about student-centered, active, modern medical education

Part of the book series: Innovation and Change in Professional Education (ICPE, volume 15)

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Softcover Book
USD 54.99
Price excludes VAT (USA)
Hardcover Book
USD 54.99
Price excludes VAT (USA)

Table of contents (10 chapters)

  1. Front Matter

    Pages i-x
  2. Backgrounds of Educating Preclinical Students in Clinical Reasoning

    1. Front Matter

      Pages 1-1
    2. Introduction

      • Olle ten Cate
      Pages 3-19Open Access
    3. Training Clinical Reasoning: Historical and Theoretical Background

      • Eugène J. F. M. Custers
      Pages 21-33Open Access
    4. Prerequisites for Learning Clinical Reasoning

      • Judith L. Bowen, Olle ten Cate
      Pages 47-63Open Access
    5. Approaches to Assessing the Clinical Reasoning of Preclinical Students

      • Olle ten Cate, Steven J. Durning
      Pages 65-72Open Access
  3. The Method of Case-Based Clinical Reasoning Education

    1. Front Matter

      Pages 73-73
    2. Case-Based Clinical Reasoning in Practice

      • Angela van Zijl, Maria van Loon, Olle ten Cate
      Pages 75-83Open Access
    3. Assessment of Clinical Reasoning Using the CBCR Test

      • Olle ten Cate
      Pages 85-94Open Access
    4. Writing CBCR Cases

      • Olle ten Cate, Maria van Loon
      Pages 95-108Open Access
    5. Curriculum, Course, and Faculty Development for Case-Based Clinical Reasoning

      • Olle ten Cate, Gaiane Simonia
      Pages 109-119Open Access
    6. A Model Study Guide for Case-Based Clinical Reasoning

      • Maria van Loon, Sjoukje van den Broek, Olle ten Cate
      Pages 121-132Open Access
  4. Back Matter

    Pages 133-207

About this book

This book is open access under a CC BY 4.0 license. 

This volume describes and explains the educational method of Case-Based Clinical Reasoning (CBCR) used successfully in medical schools to prepare students to think like doctors before they enter the clinical arena and become engaged in patient care. Although this approach poses the paradoxical problem of a lack of clinical experience that is so essential for building proficiency in clinical reasoning, CBCR is built on the premise that solving clinical problems involves the ability to reason about disease processes. This requires knowledge of anatomy and the working and pathology of organ systems, as well as the ability to regard patient problems as patterns and compare them with instances of illness scripts of patients the clinician has seen in the past and stored in memory. CBCR stimulates the development of early, rudimentary illness scripts through elaboration and systematic discussion of the courses of action from the initial presentation of the patient to the final steps of clinical management.

The book combines general backgrounds of clinical reasoning education and assessment with a detailed elaboration of the CBCR method for application in any medical curriculum, either as a mandatory or as an elective course. It consists of three parts: a general introduction to clinical reasoning education, application of the CBCR method, and cases that can used by educators to try out this method.


  • assessment of clinical reasoning
  • encapsulation of knowledge
  • context specificity
  • diagnostic bias
  • diagnostic errors
  • dual process theory
  • history of clinical reasoning
  • illness scripts
  • medical problem solving
  • peer teaching
  • problem-based learning
  • semantic qualifiers
  • Open Access

Editors and Affiliations

  • Center for Research and Development of Education, University Medical Center Utrecht, Utrecht, The Netherlands

    Olle ten Cate, Eugène J.F.M. Custers

  • Uniformed Services University of the Health Sciences, Bethesda, USA

    Steven J. Durning

Bibliographic Information

  • Book Title: Principles and Practice of Case-based Clinical Reasoning Education

  • Book Subtitle: A Method for Preclinical Students

  • Editors: Olle ten Cate, Eugène J.F.M. Custers, Steven J. Durning

  • Series Title: Innovation and Change in Professional Education

  • DOI:

  • Publisher: Springer Cham

  • eBook Packages: Education, Education (R0)

  • Copyright Information: The Editor(s) (if applicable) and The Author(s) 2018

  • License: CC BY

  • Hardcover ISBN: 978-3-319-64827-9

  • Softcover ISBN: 978-3-319-87882-9

  • eBook ISBN: 978-3-319-64828-6

  • Series ISSN: 1572-1957

  • Series E-ISSN: 2542-9957

  • Edition Number: 1

  • Number of Pages: X, 207

  • Number of Illustrations: 14 b/w illustrations

  • Topics: Medical Education, Curriculum Studies, Professional and Vocational Education

Buying options

Softcover Book
USD 54.99
Price excludes VAT (USA)
Hardcover Book
USD 54.99
Price excludes VAT (USA)