Granulocytic sarcoma of the oral cavity in a chronic myeloid leukemia patient: an unusual presentation.

UNLABELLED: The clerkship represents the initial stage of medical students' clinical practice, during which clinical reasoning training is emphasized. However, clinical reasoning training during the clerkship encounters several challenges, including limited teaching time and difficulties in adapting to the clinical environment. We developed a three-step clinical reasoning course based on David Kolb's Experiential Learning Cycle model to bridge the learning gaps in the existing clerkship model and then evaluated its impact on performance in clerkship summative evaluations. The three-step clinical reasoning course consists of three parts, including online practice, case-based clinical reasoning lessons, and role-play exercises. During the rotation in the nephrology department, eight student groups (including 50 clerkship students) were assigned to either a control group or a three-step intervention group using a quasi-experimental design. The control group received the conventional clinical reasoning course, while the three-step group received the three-step clinical reasoning course. We evaluated the two groups regarding knowledge, clinical skill, clinical reasoning and satisfaction. The mean score of clinical skills exam for patients' consultation of three-step group was significantly higher than that of the control group (88.45 ± 8.18 vs 78.13 ± 14.34, P < 0.01). The mean score on clinical reasoning tests was significantly higher in the three-step group than in the control group (24.73 ± 1.96 vs 23.18 ± 1.89, P < 0.01). Student satisfaction of three-step group was notably higher than that in the control group. The three-step course provided clerkship students with a structured, dynamic, and clinically relevant experience, enabling them to enhance their patient consultation skills and clinical reasoning.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-026-02698-4.