Module 3 · Clinical work and reasoning
Learning on shift
Choose one or two learning goals with your supervisor. With the patient’s agreement and appropriate supervision, take a focused history, examine the patient and present your findings. Follow the patient’s journey where possible: assessment, investigations, review and the plan. Learn from nurses, ACPs, doctors and the wider team, and ask how their roles fit together.
Be clear about your student role, respect consent and confidentiality, and work within your competence. Discuss your findings and proposed plan with a supervising clinician. Do not independently prescribe, discharge patients or make commitments about their care. If you are worried about a patient, alert a qualified member of staff promptly.
Explain your thinking
Move beyond listing facts: explain what they mean. For each patient, practise this sequence with your supervisor:
• Summarise the main problem and the key findings.
• Suggest the most likely explanation and important alternatives.
• Identify what remains uncertain and what further information would help.
• Explain how an investigation might change the assessment or plan.
• Reconsider your initial view when new information arrives.
A useful presentation is: “My main concern is … because … . Other possibilities are … . I would like to clarify … . My proposed next step is … .” It is fine to be uncertain. The aim is to make your thinking visible so your supervisor can help you develop it.
Before you leave each shift
Check that your supervisor knows you are leaving and that any patient-related information has been handed over. Note one thing you learnt, one question to follow up and one goal for your next shift.