D-CREDO Project

D-CREDO @ the Munich Symposium: Advancing Digital Clinical Reasoning Education




In this article, discover:

Conference Themes: Management Reasoning and Collaborative Clinical Reasoning: Emerging themes and discussions from the 3rd Munich Symposium.

Bringing Digital Innovation into Clinical Reasoning Education: D-CREDO’s Key Outcomes: The D-CREDO Contribution – How the project’s eight learning units bring digital tools into clinical reasoning education.

Building Capacity for Educational Innovation: From Faculty Development to Curriculum Implementation: Lessons from the Discussion – Key challenges and the importance of faculty development.

Building on Emerging Trends: Opportunities to Further Develop the D-CREDO Curriculum: Opportunities to strengthen management reasoning and collaborative clinical reasoning through digital and interprofessional education.

Strengthening Collaboration and Shaping the Future of Medical Education: How international exchange can inform future developments in health professions education.


On 23 October 2026, Andrzej A. Kononowicz, Associate Professor and Head of the Department of Bioinformatics and Telemedicine at Jagiellonian University Medical College in Kraków, Poland, presented the abstract “D-CREDO: An International Curriculum for Using Digital Tools to Augment Clinical Reasoning” at the 3rd Munich Symposium on Clinical Reasoning.

Clinical reasoning is central to medical competence, yet important questions remain about how it develops, how it can be supported, and how it should be assessed. The Munich Symposium brings together invited researchers and educators to examine current developments and identify future directions in this field.

The symposium also provided an opportunity for the wider D-CREDO community to come together. Among those attending were Martin Adler and Inga Hege, MD, MCompSc, Associate Professor, representing D-CREDO consortium partner Instruct gGmbH, whose work includes the development and provision of the CASUS virtual patient learning platform. The symposium also featured Steven J. Durning, MD, PhD, Professor of Medicine and Pathology at the Uniformed Services University of the Health Sciences, Bethesda, USA, as a keynote speaker. Professor Durning is also a D-CREDO Associate Partner. Their participation further highlighted the international collaboration, shared expertise and collaborative support underpinning the project.

Conference Themes: Management Reasoning and Collaborative Clinical Reasoning

The third edition of the symposium focused on two closely connected themes: the use of simulation and virtual reality to create authentic environments for clinical reasoning, and the potential of digital tools and learning analytics to make reasoning processes more visible and support their evaluation.Two more themes attracted particular attention and sparked lively discussions: the growing importance of management reasoning and collaborative clinical reasoning.

Management reasoning, alongside diagnostic reasoning, is one of the key components of clinical reasoning. Unlike diagnostic reasoning, which tends to have a clear endpoint in the form of an accurate diagnosis, management reasoning is more challenging, as it requires continuous dialogue between healthcare professionals and patients to adapt treatment and care to the patient’s evolving condition, individual preferences, and personal context.

Collaborative clinical reasoning builds on the idea that clinical reasoning is a distributed cognitive process. It requires careful coordination of activities among teams of healthcare professionals working in dynamic environments and using a variety of tools to support the exchange of clinical information and coordinate patient care. Artificial intelligence and digital health tools play a crucial role in this context, offering opportunities to enhance the quality of clinical reasoning processes and improve how future healthcare professionals are trained in these skills.


Participants were welcomed to Bayerische Akademie der Wissenschaften


Bringing Digital Innovation into Clinical Reasoning Education: D-CREDO’s Key Outcomes 

Within this context, the D-CREDO presentation showcased the project’s work on developing an international curriculum focused on using digital tools to augment clinical reasoning in health professions education. It focused on demonstrating the tangible outcomes of the project. The presentation was structured around the eight student learning units developed within the project. For each learning unit, at least one activity was selected and briefly presented to give the audience a taste of what the modules have to offer. It highlighted the relevance of integrating
digital technologies into educational practice and explored their potential to support the development and assessment of clinical reasoning skills.

Building Capacity for Educational Innovation: From Faculty Development to Curriculum Implementation

The questions following the presentation focused primarily on the practical aspects of integrating the learning units into existing curricula. The effort required for this process is often underestimated, as introducing new content into already heavily loaded study programmes is challenging. These difficulties are further compounded by resistance to change, which may stem partly from insufficient faculty competencies in the areas addressed by the innovative educational content. This challenge can be addressed through targeted faculty development activities that help educators build the necessary knowledge, skills, and confidence to adopt new approaches to teaching. These considerations align closely with the priorities of D-CREDO for the third year of the project, during which implementation planning will be a prominent focus.


Building on Emerging Trends: Opportunities to Further Develop the D-CREDO Curriculum

Popular conference themes, such as management reasoning and collaborative reasoning, align with several learning units developed by the D-CREDO consortium. For instance, some of our modules address the benefits of monitoring patients’ disease status using mobile apps, such as diabetes management apps or migraine e-diaries, as well as using these applications to engage in dialogue with patients about the collection and interpretation of their medical data. However, we could further strengthen the modules by incorporating more discussion of the relationship between diagnostic reasoning and management reasoning. Collaborative clinical reasoning is fostered through interprofessional education. Although we have developed learning units tailored to the needs of both nurses and physicians, the modules are primarily designed for monoprofessional education. A follow-up project could therefore focus on developing explicitly interprofessional learning scenarios that integrate collaborative clinical reasoning and digital tools.

By contributing to the symposium discussions, D-CREDO helped advance dialogue on how digital innovation can support the preparation of future healthcare professionals for increasingly technology-enabled clinical environments.


Talks and discussions continued at Carl Friedrich von Siemens Stiftung


Strengthening Collaboration and Shaping the Future of Medical Education

Participation in the 3rd Munich Symposium on Clinical Reasoning provided D-CREDO with a valuable opportunity to share its achievements, exchange ideas with researchers and educators, and engage with emerging developments in the field. The discussions highlighted not only the growing role of digital technologies in clinical reasoning education but also the importance of management reasoning, collaborative approaches, and effective curriculum implementation.

The symposium also offered valuable perspectives for the further development of D-CREDO’s learning units, particularly regarding faculty development, the integration of management reasoning, and opportunities to strengthen interprofessional education. These insights will help inform the project’s next steps and support its ambition to make digital innovation a meaningful part of health professions education.

By actively contributing to international academic discussions, D-CREDO continues to build connections, share knowledge, and promote innovative educational approaches that prepare future healthcare professionals for the increasingly complex and technology-enabled healthcare environment.

Stay connected with D-CREDO! Follow us on LinkedIn for the latest project updates, insights, and stories about our work to shape the future of medical education.

#DCREDO #MedicalEducation #ClinicalReasoning #DigitalEducation #InternationalCooperation #HigherEducation

Virtual Patients (VPs)

The virtual patients integrated into the D-CREDO and DID-ACT learning units are partly taken from the EU-funded project iCoViP and form the collection for deliberate practice. The virtual patients are freely accessible via the CASUS system at https://crt.casus.net and a description of available VPs with key symptoms and final diagnoses is available in this blueprint. Thus, you can choose VPs suitable for your students and also offer them the whole collection for longitudinal and deliberate practice.

Participants: Multi-professional educators (nurses, physicians, paramedics)

Learning units: What is Clinical Reasoning and Models
Level: Teacher

Description: Offered as additional faculty development opportunity to staff members of the Medical Education Department.
Mode: Option / additional part to the faculty development program with emphasize on the educational potential of clinical reasoning teaching techniques

Technical Integration: Access to the DID-ACT Moodle via EduGain, synchronous sessions were held face-to-face.

Tips & Tricks: Give participants time to familiarize themselves with the learning material between the sessions. Do not put too much in one day - better to meet twice for shorter sessions. Face-to-face sessions lead to more productive discussions than Zoom meetings. Focus on discussion with the audience and on examples from practical teaching to illustrate the learning objectives.

Participants: Multi-professional educators

Learning units: Differences and similarities in clinical reasoning among health professions
Level: Teacher

Description: Offered as part of the faculty development program, it was held as a blended learning course with the synchronous phase online.
Mode: Part of the faculty development program with certificate

Technical Integration: Access to the DID-ACT Moodle via EduGain, synchronous sessions were held online via Zoom.

Tips & Tricks: Give good practical information how Moodle works and how the participants can find and work with the different assigments of the learning unit. Emphasize the importance to the participants to work with the different individual tasks, as the discussions will be more interesting and fruitful. Also important that all the participants from different occupations feel comfortable to meet and that they all are a part of the discussion. This is an important and maybe the primary task for the facilitator!

Participants: Multi-professional and international educators

Learning units: Clinical Reasoning teaching and assessment & What is Clinical Reasoning and Models
Level: Teacher

Description: Offered as optional learning unit for participants of the Master of Medical Education (MME) program in Bern/Switzerland.
Mode: Part of the faculty development program with certificate

Technical Integration: Access to the DID-ACT Moodle via EduGain, synchronous sessions were held face-to-face.

Tips & Tricks: To foster a valuable learning experience it is indispensible to provide good case examples that are tailored to the needs and experiences of the participants, so that they can relate to their prior knowledge. Thus, the provided examples in this learning units might need some adaptations for your target group of educators.

Participants: Multi-professional educators across German-speaking coutries

Learning units: Differences and similarities in clinical reasoning among health professions
Level: Teacher

Description: Offered as part of the faculty development program at the University of Augsburg, but open to participants from Germany, Austria, and Switzerland. It was held as a blended learning course with the synchronous phase online. Participants were eager to exchange their experience and disucss their views across institutions and professions.
Mode: Part of the faculty development program with certificate

Technical Integration: Access to the DID-ACT Moodle via EduGain, synchronous sessions were held online via Zoom.

Tips & Tricks: To foster a valuable interprofessional experience the participants should represent a balanced mix of professions and also ideally the facilitators should at least represent two different professions. This allows a good discussion and also guarantees that the small groups can work interprofessionally. Our experience with a less-balanced group composition was that the over-represented profession dominates the discussions and it was quite difficult to counter-balance this.

Target group: Medical students in year 2

Learning units: Person-centered approach to clinical reasoning
Level: Novice

Description:The Learning Unit was run as an extra-curricular session as a virtual class. The facilitators were trained on this topic by attending the Train-the-trainer learning unit on "Person-centered approach and the role of patients".
Mode: Extracurricular activity

Technical Integration: Access to the DID-ACT Moodle via EduGain, synchronous sessions were held online via NewRow.

Tips & Tricks: Learning objective cross-referencing with the existing curriculum helps identify the level of integration. Encouraging and helping students to get familiar with Moodle before the session facilitates a smooth integration of the asynchronous phases.

Target group: Medical students in year 4 and 5

Learning units: Generating differential diagnoses and deciding about final diagnoses
Level: Novice

Description: The learning unit was integrated into a pediatric emergency department clerkship with a relation to virtual patients already used in this clerkship. Facilitators were trained by attending the train-the-trainer unit on "Information gathering, Generating differential diagnoses, Decision making, and Treatment planning".
Mode: Part of a regular curricular activity

Technical Integration: Access to the DID-ACT Moodle via EduGain, synchronous sessions were held face-to-face.

Tips & Tricks: Integration into clerkships works well, especially with a relation to already used content.

Target group: Medical students in year 1-6

Learning units: All 25 learning units of the DID-ACT curriculum
Level: Novice - Advanced

Description:
Longitudinal integration of the DID-ACT learning units into a clinical skills & communication course with the following suggested distribution across years:
Year 1: What is Clinical Reasoning, Person-centered approach to clinical reasoning, Health profession roles in clinical reasoning, and Biomedical Knowledge & Clinical Reasoning. (Required time in curriculum ca. 5 hours / semester)
Year 2: Dual Process Theory, Illness scripts, Collect and prioritize key clinical findings/problems, and What is clinical reasoning and How can theories be put into practice (Intermediate). (Required time in curriculum: ca. 4 1/2 hours/semester)
Year 3: Generating differential diagnoses and deciding about final diagnosis, Biases and cognitive errors - an Introduction, Analyzing and avoiding errors. (Required time in curriculum: ca. 4 1/2 hours/semester)
Year 4: Using the Outcome Present State Test Model, Developing a treatment plan, Metacognition, reflection and models for reflection, Collaboration of health professions in Clinical Reasoning (Intermediate). (Required time in curriculum: ca. 6 hours/semester)
Year 5: All remaining intermediate learning units: Shared Decision Making in Clinical Reasoning, Decision Support Systems, Ethical aspects - patient management and treatment, Uncertainty. (Required time in curriculum: ca. 5 hours/semester)
Year 6: All 6 advanced learning units: Collaborate with others in clinical reasoning, Decision Support Systems, Biases and cognitive errors, Uncertainty, Metacognition, reflection and models for reflection, Analyzing and avoiding errors.
(Required time: ca. 6 hours / semester. Final year students often have a day/week off from clinical work so these days could be used for DID-ACT learning units and optional participation in the train-the-trainer units)
Years 1-5: Virtual Patients (VPs) as additional deliberate practice activities in increasing number and complexity (e.g. starting with 5 VPs (=ca. 1.5 hours)/semester) in Year 1 and increasing to 10 VPs/semester) in Year 3-5.
Mode: Integrated into a clinical longitudinal course that runs from year 1 to 6 resulting in a total of 2.4 ECTS.

Technical Integration: Access to the DID-ACT Moodle via EduGain, synchronous sessions face-to-face or online.

Tips & Tricks:
Alining a longitudinal curriculum with curricula of other health professions remains a challenge and requires careful and early planning, but the asynchronous phases might be a good starting point for interprofessional teaching sessions. The VPs can be quite easily aligned with other curricular courses e.g., based on key symptoms.

Target group: Medical students in year 3

Learning units: Person-centered approach to clinical reasoning
Level: Novice

Description: The learning unit was integrated into the Laboratory Training of Clinical Skills. This course consists of six face-to-face meetings for groups of around 10 students. Within the meetings the students discuss various topics related to communication skills and person-centered approach. The fifth of the six meetings of the course was replaced by the DID-ACT learning unit. Students could then refer back to this learning unit during final session of the course.
Mode: Part of a regular curricular activity

Technical Integration: Access to the DID-ACT Moodle via EduGain, synchronous sessions were held face-to-face. If possible, a uniform technology to provide access to the online resources in the class (using university tablets in our case) and support of the technical staff on-site was helpful to lower the technical barrier.

Tips & Tricks: Changing of the standard format of classes is interesting and motivating for the students. Virtual patients are a tool to present authentic clinical scenarios which are appreciated by the students. A blend of role-play and virtual patients allows students to take advantages of the two methods to reach the learning objectives.

Target group: Medical students in year 2 and nursing students in year 3 across Europe

Learning units: Collaboration of Health Professions in Clinical Reasoning
Level: Intermediate

Description:
This learning unit was implemented with , aside from clinical reasoning, tow additional objectives: 1) providing internationalization experience for students without traveling. 2) Deepening the knowledge of one's own professional roles and responsibilities and knowledge of another profession .
Mode: Extra-curricular interprofessional learning session with international participants

Technical Integration: Self-registration on DID-ACT Moodle, synchronous sessions via zoom.

Tips & Tricks: Facilitators running this course and supporting the discussions should be careful about supporting and encouraging all the participating professions' perspectives.

Target group: Medical students in year 1 and 2 (preclinical) across Europe

Learning units: Introduction into Clinical Reasoning & Health profession roles in clinical reasoning
Level: Novice

Description: The course was offered as a blended learning module to students from different medical schools in Europe as an international elective. Synchronous phases were held online via Zoom. The international aspect was very motivating for students and they learnt a lot from each other by exchanging their perspectives and how they are taught clinical reasoning vaspects. This teaching mode could also be implemented as an activity to welcome or prepare new Erasmus students. Facilitairs were trained by attending the train-the-trainer learning unit on "Differences and similarities in clinical reasoning among health professions".
Mode: Elective course

Technical Integration: Self-registration on DID-ACT Moodle, synchronous sessions via zoom and use of Padlet for interactivities.

Tips & Tricks: The organization with the registration of students was a bit complex, so, we suggest just setting dates and let students book. Allow enough (more time) for discussion and introduction rounds as participants do not know each other and are eager to hear and learn from peers at other schools and countries. Ideally, this session could also be held interprofessionally, however, it makes the finding of suitable dates even more complex.

How to teach synchronously in a virtual setting

  • You need a reliable camera, microphone, and virtual platform and be familiar with its features, such as whiteboard, chat, polling, breakout rooms, etc.
  • At the beginning establish communication rules, e.g. whether participants should raise their (virtual) hand, use the chat, and/or just speak. Also, we recommend asking participants to turn on their camera
  • For small group work break out rooms work very well, just be clear about the tasks the groups should work on prior to dividing them into the groups.
  • For collaboration the use of integrated virtual whiteboards or other platforms such as Padlet are very useful. Just make sure prior to the session that you have everything setup and the links at hand, e.g. to post them in the chat.
  • Allow a bit more time for starting the session and the group works as there might be participants who are not familiar with the platform or technical problems might occur.

How to motivate unprepared participants

  • Make clear that the asynchronous assignments are a core part of the course and that its content will not be repeated. Even if it is difficult, stick to that when starting the synchronous teaching session.
  • If you expect unprepared participants, you can start the session with a student-centered group exercise mixing prepared and unprepared students to increase peer-pressure and make them realize that being unprepared does not feel good.  
  • Use the introductory or closing quizzes / tests so that participants can self- assess whether they have the required knowledge and you as a facilitator can see the level of knowledge and preparation of your participants.

Further recommended reading:

How to involve participants with different levels of experience

  • To account for such different levels, we recommend making use of the asynchronous preparatory phases which also include introductory quizzes in which participants can self-assess their prior knowledge and you as a facilitator can assess the differences within your group. Participants with less prior experience can also be guided to additional preparatory resources.
  • Encourage participants to work in pairs or small groups when preparing so that they can help and learn from each other. You could even facilitate this by dividing them into groups with different levels of experience.
  • Similarly, during the synchronous phases, we recommend forming groups with participants different levels of experience and emphasize the peer support aspects of such group activities.
  • We also recommend starting with rather smaller groups and allow more time than stated in the course outlines, if you expect a heterogenous level of experience. This way you can better manage this challenge.
  • Encourage your participants to ask questions, emphasizing that nobody knows everything and that it is important for learning to ask questions.  
  • Especially in the train-the-trainer course you might have to deal with over-confident participants, who especially in an interprofessional setting can dominate the group. This is a complex cultural challenge, but you could try to establish (and follow) communication rules at the beginning of a session.  

How to address potential overlaps or redundancies

  • Identify what is already included and what is missing in your curriculum related to clinical reasoning outcomes and compare it to the DID-ACT blueprint. Prioritize learning outcomes that are not yet covered but regarded as important.
  • Identify activities, resources, or teaching sessions with similar learning outcomes that might be in need for change anyway because of low evaluation results, teachers or students struggle with it. These could be suitable for adding or replacing parts with DID-ACT activities.
  • Ask teachers and students about overlaps and gaps they see in their teaching / learning of clinical reasoning and where they struggle. This could also be done by a reflection round after related teaching activities in the curriculum
  • Although ideally a longitudinal integration is aimed at, we recommend to starting small with a pilot implementation to gain experience and develop a show case.

How to teach in an interprofessional setting

  • Allow for enough time prior to the teaching for the organization and motivation / encouragement of stakeholders and participants
  • Allow for enough time and guidance during the course so that the participants from the different professions can get to know each other and their professions and discuss their different perspectives. This might mean that you need to calculate some extra time in addition to the suggested duration of the learning unit.
  • There may be a different understanding of clinical reasoning in the different health professions, so we recommend making participants aware of this. You could for example use and adapt activities from the learning units on the health profession roles to facilitate this.
  • Courses in an interprofessional setting should not come too early in the curriculum (not before professions have formed their own professional identity - however, this also depends on the aim of the course). 
  • Make sure you have enough participants from different professions. If possible, the facilitator could divide the participants in smaller groups with an equal distribution of professions. 
  • Similarly, you need an equal distribution of facilitators / facilitators from different professions.
  • Develop customized learning materials considering the different professions. If needed you can adapt the material and activities provided in the DID-ACT curriculum.

Further recommended reading:

van Diggele, C., Roberts, C., Burgess, A. et al. Interprofessional education: tips for design and implementation. BMC Med Educ 20, 455 (2020). (Link)

Curricular Implementation of D-CREDO tools: Telehealth

In this learning unit educators will design, adapt, and implement clinical reasoning learning activities that integrate telehealth settings. The focus is on practical curricular integration: embedding telehealth into existing teaching activities, creating realistic simulations, and addressing ethical/legal responsibilities. Participants will explore how to adapt clinical reasoning scenarios, facilitate telehealth simulations, and critically assess its affordances and limitations. Special attention is given to responsible use, safeguarding privacy, and supporting students in navigating both technical and cognitive challenges.
By the end of the unit, participants will facilitate learning experiences that help students apply telehealth in clinical reasoning process effectively and with ethical safety.

Theme(s): Ethical aspects, Teaching CR
Level: Educator
Format: Blended Learning
Recommended ECTS: -
Links: Educator Course

Curricular Implementation of D-CREDO tools: EHR

In this learning unit educators will be encouraged to share their experience with different EHRs, analyze their strengths and weaknesses, and develop their own teaching concept for the EHR learning unit. The concepts will be reviewed and discussed with colleagues and a tutor. The aim is to empower educators to adapt and implement their own concept for this LU into their teaching enviroment.

Theme(s): Ethical aspects, Teaching CR
Level: Educator
Format: Blended Learning
Recommended ECTS: -
Links: Educator Course

Curricular Implementation of D-CREDO tools: CDSS

In this learning unit, educators will develop their own teaching concept for use CDSS in clinical reasoning education, with a special emphasis on the use of differential diagnosis generators. During the asynchronous phase, educators will explore the educational potential of DDX generators and symptom checkers. Educators will experience and reflect on the teaching potential of CDSS by applying it to a virtual patient from the iCoViP collection. The proposed teaching concepts will be reviewed and discussed with colleagues and a facilitator during the synchronous phase of the LU and compared with findings from the literature. In the assessment phase educators will also be encouraged to apply their generated teaching concept around the use of DDX generators and symptom checkers with individual students or small groups during their classroom or clinical teaching. Additional optional tasks are provided for groups with more time available, allowing for broader discussion of the use of CDSS in clinical reasoning education (not limited to symptom checkers) and of the impact of patient use of CDSS on the patient-doctor relationship in the context of clinical reasoning.

Theme(s): Ethical aspects, Teaching CR
Level: Educator
Format: Blended Learning
Recommended ECTS: -
Links: Educator Course

Analyzing and avoiding errors

This learning unit will provide general and specific aspects of a morbidity and mortality conference and apply the knowlege by working through a case report.

Theme(s): Biases & errors
Level: Advanced
Format: Asynchronous online preparation (ca. 60 min) followed by a synchronous meeting (ca. 90 min)
Recommended ECTS: 0.08
Links: Student course - Facilitator resources

Metacognition, reflection and models for reflection

Similar to the novice learning unit learners are asked to complete a reflective diary for five days. However, in this learning unit they should focus on critical or difficult situations in the clinical context.

Theme(s): Errors & biases
Level: Advanced
Format: Asynchronous online preparatory phase (ca. 60 min) with a synchronous follow-up meeting (ca. 60 min)
Recommended ECTS: 0.07
Links: Student course - Facilitator resources

Theories of Clinical Reasoning

Uncertainty

In this learning unit, the approach of practice inquiry will be introduced and applied.

Theme(s): Biases & errors
Level: Advanced
Format: Asynchronous online preparation (ca. 60 min) followed by a synchronous meeting (ca. 60 min)
Recommended ECTS: 0.07
Links: Student course - Facilitator resources

Curricular Implementation of D-CREDO tools: AI Image Analysis

In this learning unit educators will be able to develop their own teaching concept for the student learning unit on CR with AI-assisted image analysis. The concepts will be reviewed and discussed with colleagues and a tutor. The aim is to empower educators to adapt and implement their own concept into their teaching.

Theme(s): Teaching CR
Level: Educator
Format: Blended Learning
Recommended ECTS: -
Links: Educator course

Curricular Implementation of D-CREDO tools: mHealth and wearables

This learning unit prepares health professions educators to design, adapt, and implement CR learning activities that integrate digital health technologies such as mHealth tools and wearables. The focus is on practical curricular integration: embedding these tools into existing teaching activities, creating realistic simulations, and addressing ethical/legal responsibilities. Participants will explore how to adapt CR scenarios and critically assess the affordances and limitations of these tools. Special attention is given to responsible use, safeguarding privacy, and supporting students in navigating both technical and cognitive challenges.
By the end of the unit, educators will be equipped to facilitate learning experiences that help students apply digital technologies in clinical reasoning process effectively and with ethical safety.

Theme(s): Ethical aspects, Teaching CR
Level: Educator
Format: Blended Learning
Recommended ECTS: -
Links: Educator Course

Designing and Adapting Clinical Reasoning Educational Activities with Generative AI

This learning unit empowers educators to integrate the student learning units on LLMs into their teaching and assessment of clinical reasoning. They will be able to adapt the provided materials to their needs and support students in using LLMs in their clinical reasoning process.

Theme(s): Self-reflection & attitudes, Teaching CR
Level: Educator
Format: Blended Learning
Recommended ECTS: ....
Links: Student course - Facilitator resources

Role of Digital Tools in Clinical Reasoning Teaching and Responsive Use of Digital Tools in Clinical Reasoning

The learning unit is designed to encourage and enable educators to familiarize themselves with the D-CREDO digital tools. They will explore the strengths and limitations of these tools as well as rules and regulations that need to be considered within their teaching environment. 

Theme(s): Theories of CR, Teaching CR
Level: Educator
Format: Blended Learning
Recommended ECTS: ....
Links: Student course - Facilitator resources

Responsible Use of Digital Tools

In this learning unit, intermediate-level medical and nursing students are introduced to the responsible use of digital tools. Students explore ethical and legal implications using real-world examples and checklists or guidelines for assessing the trustworthiness and risks of digital tools. Then, students apply a digital tool for solving a virtual patient and evaluate the tool's practical utility, focusing on potential biases. Working in groups, students discuss and decide whether to trust the digital tool.

Theme(s): Ethical aspects, Errors & Biases
Level: Intermediate
Format: Bledned Learning
Recommended ECTS: ....
Links: Student course - Facilitator resources

Clinical Reasoning with Clinical Decision Support System

In this learning unit students can familiarize themselves with clinical decision support systems by applying them in a virtual patient scenario. They also discuss advantages, risks, recommendation on how to use these tools in the context of clinical reasoning, and future potentials.

Theme(s): Gathering, interpreting & synthezising information
Level: Intermediate
Format: Blended Learning
Recommended ECTS: ....
Links: Student course - Facilitator resources

Large Language Models

This unit helps intermediate-level medical and nursing students explore how large language models (LLMs) influence clinical reasoning. Through hands-on prompt engineering and critical reflection, students learn to use LLMs for generating differential diagnoses and treatment plans. They also examine how AI-assisted decision-making can shape, support, or bias their own clinical reasoning processes.

Theme(s): Self-reflection & attitudes, Generating DDX
Level: Intermediate
Format: Blended Learning
Recommended ECTS: ....
Links: Student course - Facilitator resources

Clinical Reasoning at Distance

This learning unit introduces novice medical and nursing students to clinical reasoning in telehealth settings. They learn to gather information, generate differential diagnoses, and develop treatment plans during remote consultations, while reflecting on the unique opportunities and limitations of virtual care.

Theme(s): Developing treatment plan, Gathering info, Generating DDX
Level: Novice
Format: Blended Learning
Recommended ECTS: ....
Links: Student course - Facilitator resources

Mobile Apps and Wearables in Clinical Reasoning

This learning unit introduces students to the principles of clinical reasoning as applied to mHealth applications. After introducing the different subgroups of mHealth tools and their implications for clinical reasoning, students work in small groups on case examples that include mHealth application. They will discuss how to interpret the information, consider benefits and pitfalls, and decide on appropriate clinical actions.

Theme(s): Gathering info
Level: Advanced
Format: Blended learning
Recommended ECTS: ....
Links: Student course - Facilitator resources

Electronic Health Records

In this learning unit, students are invited to discuss about their experiences with EHRs and their potential. They will then compare and contrast the functionalities of different EHR systems including systems students are using in their clinical work. Finally, students will develop a treatment plan for a virtual patient in an EHR and discuss their work.

Theme(s): Gathering info
Level: Advanced
Format: Blended Learning (ca. 180 min)
Recommended ECTS: ....
Links: Student course - Facilitator resources

Using digital tools for image analysis in clinical reasoning

In this learning unit medical students will experience the potential of AI tools for image analysis in clinical reasoning in different disciplines, such as radiology, dermatology, and cardiology. Using short virtual patients students can experiment with the AI tools and discuss about potential benefits and risks.

Theme(s): Decision Making, Generating DDX
Level: Intermediate
Format: ...
Recommended ECTS: ...
Links: Student course - Facilitator resources

Foundations of Digital Technologies in Clinical

This learning unit enables novice students to recognize when digital health tools become integral to the clinical reasoning process. The learning activities are grounded in the theoretical framework of Distributed Cognition Theory. The primary goals for students is to understand (1) that clinical reasoning occurs within a system comprising different types of tools and embedded in an organizational context and (2) how the tools support humans in performing a task or solving a problem.

Theme(s): Theories of Clinical Reasoning
Level: Novice
Format: Blended Learning(ca. 180 min)
Recommended ECTS: ....
Links: Student course - Facilitator resources

Theoretical / Background Knowledge

These resources and activities summarize all topics from the student learning units to introduce educators to these concepts. These resources are part of the train-the-trainer courses and marked as "optional" . Thus, they can be used optionally by course facilitators if participants are not yet familiar with basic concepts.

Theme(s): All basic concepts of clinical reasoning
Level: Educators
Format: Additional resources and material provided for each train-the-trainer learning unit that can be integrated if needed, e.g. if participants are quite new to the topic. These resources cover the basic concepts of a topic without going into the teaching aspects, so they can be used as preparatory steps.

Ethical aspects - patient management and treatment

his learning unit provides an introduction into bioethical principles, consent, capacity, and ethical clinical reasoning.

Theme(s): Ethical Aspects
Level: Intermediate
Format: Asynchronous online preparatory phase (ca. 60 min) with a synchronous follow-up meeting (ca. 90 min)
Recommended ECTS: 0.08
Links: Student course - Facilitator resources

Biases and cognitive errors

This learning unit introduces additional errors and biases and your will have the opportunity to work on virtual patients to identify error-prone situations.

Theme(s): Biases & errors, Ethical aspects, Theories of clinical reasoning
Level: Advanced
Format: Asynchronous online preparataion (ca. 60 min) for a follow-up synchronous meeting (ca. 90 min)
Recommended ECTS: 0.08
Links: Student course - Facilitator resources

Shared Decision Making in Clinical Reasoning

In this learning unit, learners will be familiarized or re-familiarized with the basic concept of shared decision-making (SDM) in a way that serves as a steping stone for how to implement key concepts and models into practice. A job aid on shared decision-making will be a takeaway from this learning unit.

Theme(s): Patient Perspective, Decision Making
Level: Intermediate
Format: Asynchronous online preparation (ca. 60 min) with a follow-up synchronous meeting (ca. 90 min)
Recommended ECTS: 0.08
Links: Student course - Facilitator resources

Collaboration of health professions in clinical reasoning

In this learning unit you will be able to apply interprofessional aspects of clinical reasoning and understand similarities and differences between the clinical reasoning of health professions. This facilitates a better communicate across professions in the clinical reasoning process to meet the needs of the patient.

Theme(s): (Interprofessional) Collaboration
Level: Intermediate
Format: Starting with two synchronous meetings (each 60 min or combined) followed by an asynchronous follow-up (ca. 60 min)
Recommended ECTS: 0.1
Links: Student course - Facilitator resources

Decision Support Systems

The aim of this learning unit is to facilitate a discussion about which aspects of clinical reasoning can be supported by artificial intelligence and what the limitations of machines in clinical reasoning are.

Theme(s): Gathering, interpreting, and synthesizing information, Decision making
Level: Intermediate
Format: Synchronous meeting (ca. 90 min) with a follow-up asynchronous phase (ca. 90 min)
Recommended ECTS: 0.1
Links: Student course - Facilitator resources

Evaluation of Clinical Reasoning

This learning unit provides an overview about surveys and questions suitable to evaluate clinical reasoning teaching. It also introduces the relevance of learning analytics.

Theme(s): Teaching clinical reasoning
Level: Educators
Format: Self-guided on-demand course with different material on clinical reasoning evaluation (ca. 60 min)
Recommended ECTS: 0.03
Links: Course

Discussing and teaching about cognitive errors and biases

In this learning unit participating educators and clinicians will have the opportunity to share ideas on how a culture for discussing errors should look like. They will also learn more about most common errors and biases in clinical resoning and (teaching) strategies on how to avoid these. This learning unit supports educators in teaching the student courses on the novice level: Biases and cognitive errors, Uncertainty, and Analyzing & avoiding errors

Theme(s): Teaching clinical reasoning, Errors & biases, Theories of clinical reasoning, Ethical aspects
Level: Educators
Format: Asynchronous preparation (ca. 60 min) followed by a synchronous meeting (ca. 90 min). Optional additional activities are provided for beginners (ca. 80 min).
Recommended ECTS: 0.08 (including optional phase: 0.13)
Links: Participant course - Facilitator resources

Information gathering, Generating differential diagonses, Decision making, and Treatment planning

This learning unit is designed to support educators in implementing the student courses on Collect and prioritize key clinical findings/problems, Generating differential diagnoses and deciding about final diagnosis, Developing a treatment plan, and Biomedical Knowledge and Clinical Reasoning

Theme(s): Teaching clinical reasoning, Gathering, interpreting & synthesizing information, Generating differential diagnoses, Developing a treatment / management plan, Decision making, Ethical aspects
Level: Educators
Format: Asynchronous preparation (ca. 60 min) followed by a synchronous meeting (ca. 60 min). Optional additional activities for beginners are available (ca. 60 min).
Recommended ECTS: 0.07 (including optional phase: 0.1)
Links: Participant course - Facilitator resources

Person-centred approach and the role of patients

This learning unit prepares educators to comprehensively and confidently teach the the learning unit on Person-centred approach to clinical reasoning. This unit will take educators through the learning content provided in the learning unit, as well as supports them in familiarizing themselves with the resources and exercises. Educators will have the opportunity to create their own teaching notes as part of this learning unit.

Theme(s): Teaching clinical reasoning, Patient perspective
Level: Educators
Format: Asynchronous preparation (ca. 60 min), followed by a synchronous meeting (ca. 90 min). Optional additional activites are available for beginners (ca. 100 min).
Recommended ECTS: 0.08 (including optional phases: 0.14)
Links: Participant course - Facilitator resources

Differences and similarities in clinical reasoning among health professions

This learning unit introduces teaching methods for clinical reasoning in different healthcare professions and prepares educators to teach the learning units on Health profession roles in clinical reasoning

Theme(s): Teaching clinical reasoning, (Interprofessional) collaboration
Level: Educators
Format: Asynchronous preparation (ca. 60 min) followed by a synchronous meeting (ca. 70 min). Optional additional activities provided for beginners (ca. 120 min).
Recommended ECTS: 0.07 (including optional phases: 0.14)
Links: Course,Facilitator resources

What is Clinical Reasoning and Models

This learning unit familiarizes healthcare profession educators on teaching aspects related to the clinical reasoning process and terminology of the different health professions. This includes how to explain the importance of clinical reasoning in the different health professions to students and how to support students in reflecting on clinical reasoning theories. The learning unit prepares you for teaching the novice courses on What is clinical reasoning, Dual Process Theory, Outcome Present State model, and Illness scripts.

Theme(s): Teaching clinical reasoning, Theories of clinical reasoning
Level: Educators
Format: Two synchronous meetings (ca. 60 and 45 min) with asynchronous phase (ca. 45 min) in between. Optional additional phase with ca. 45 min.
Recommended ECTS: 0.08 (including optional phase: 0.11)
Links: Course, Facilitator resources

Clinical Reasoning teaching and assessment

This learning unit provides and overview about teaching and assessment methods for clinical reasoning. It also highlights some general apsects, such as the importance of constructive alignment or how to organize group discussions.

Theme(s): Teaching clinical reasoning
Level: Educators
Format: Self-guided on-demand course with different material on clinical reasoning teaching and assessment.
Recommended ECTS: 0.03
Links: Course

DID-ACT clinical reasoning curriculum

This learning unit provides an overview about the DID-ACT student curriculum including all course outlines and resources neede to implement these learning units. It also introduces a tutorial on how to read the course outlines and use the provided resources.

Theme(s): Teaching clinical reasoning
Level: Educators
Format: Self-guided on-demand course with different material on our DID-ACT curriculum including all course outlines for student learning units and material needed.
Links: Course

Analyzing and avoiding errors

Along a case report this learning unit introduces the root cause analysis (RCA) to analyze errors and start to find ways for preventing / avoiding errors.

Theme(s): Errors & Biases
Level: Novice
Format: Asynchronous preparation (ca. 90 min) followed by a synchronous meeting (ca. 70 min)
Recommended ECTS: 0.09
Links: Student course - Facilitator resources

Metacognition, reflection and models for reflection

In this learning unit reflection models will be introduced and self-reflection will be applied on form of a reflective diary.

Theme(s): Errors & biases
Level: Novice
Format: Synchronous meeting (ca. 60 min), followed by an asynchronous online phase (ca. 80 min) and a concluding synchronous meeting (ca. 80 min)
Recommended ECTS: 0.12
Links: Student course - Facilitator resources

Uncertainty

The aim of this learning unit is to introduce situations of uncertainty and strategies that can be applied in such situations to avoid errors.

Theme(s): Errors & biases
Level: Intermediate
Format: Asynchronous preparation (ca. 60 min) followed by a synchronous session (ca. 90 min)
Recommended ECTS: 0.08
Links: Student course - Facilitator resources

Biases and cognitive errors - an Introduction

This learning unit provides a basic introduction into the topic of biases and cognitive errors. It introduces a selection of common biases, such as premature closure or confirmation bias with providing the opportunity to elaborate on these biases with case vignettes.

Theme(s): Errors & biases, Theories of clinical reasoning, Ethical aspects
Level: Novice
Format: Asynchronous preparation (ca. 70 min) with a follow-up synchronous meeting (ca. 90 min)
Recommended ECTS: 0.09
Links: Student course - Facilitator resources

Developing a treatment plan

This learning unit provides an introduction into the topics "EBM in the context of clinical reasoning" and "developing a treatment/management plan" for students with no or some prior clinical experience.

Theme(s): Developing a treatment / management plan, Ethical aspects, Patient perspective
Level: Novice
Format: Asynchronous preparation (ca. 45 min) followed by a synchronous meeting (ca. 80 min)
Recommended ECTS: 0.08
Links: Student course - Facilitator resources

Generating differential diagnoses and deciding about final diagnosis

This learning unit introduces different methods of creating and organizing differential diagnoses. There is also opportunity to practice the finding of differential diagnoses as well as discriminating and confining features on a prototypical case.

Theme(s): Generating differential diagnoses, Decision Making
Level: Novice
Format: Two synchronous meetings (ca. 90 min each) with an asynchronous phase in between (ca. 60 min)
Recommended ECTS: 0.13
Links: Student course - Facilitator resources

Collect and prioritize key clinical findings/problems

This learning unit highlights how to collect and prioritize key clinical findings using case examples.

Theme(s): Gathering, interpreting & synthesizing information
Level: Novice
Format: Asynchronous preparatory phase (ca. 45 min) followed by a synchronous meeting (ca. 60 min)
Recommended ECTS: 0.06
Links: Student course - Facilitator resources

Biomedical Knowledge and Clinical Reasoning - Knowledge Encapsulation

This learning unit explains the interconnection of biomedical knowledge and differential diagnoses formulation and explores different techniques to visualize encapsulated knowledge.

Theme(s): Theories of Clinical Reasoning
Level: Novice
Format: Two synchronous sessions (ca. 60 min each) with an asynchronous learning phase in between (ca. 45 min)
Recommended ECTS: 0.09
Links: Student course - Facilitator resources

Person-centered approach to clinical reasoning

The goal of this learning unit is to define what a 'person perspective' is in the context of healthcare provision and highlight why it is important when providing a quality healthcare experience. Learners will also visit the definitions of biomedical information as well as recite the terminology "diagnostic and analysis" in a way that helps patients and their families understand this stage in healthcare provision. Lastly, learners will combine the above into practical ability using questions that promote support for families and patients using terminology that facilitates mutual understanding.

Theme(s): Patient perspective
Level: Novice
Format: A synchronous meetings (ca. 90 min), with a preparatory and a follow-up asynchronous phase (ca. 90 and 45 min)
Recommended ECTS: 0.13
Links: Student course - Facilitator resources

Collaborate with others in clinical reasoning

This learning unit provides basic knowledge within different healthcare professions or across medical specialisations e.g. surgery, internal medicine and their collaboration with others in clinical reasoning.

Theme(s): (Interprofessional) Collaboration
Level: Advanced
Format: Asynchronous online preparation (ca. 60mins) for a follow-up synchronous meeting (ca. 90 mins)
Recommended ECTS: 0.08
Links: Student course - Facilitator resources

Health profession roles in clinical reasoning

This learning unit provides an introduction to the various health professions involved in health care on the subject of clinical reasoning. The unit has been developed for beginner and novice learners, and is appropriate for those who have and have not yet had extensive clinical experience due to the team aspect of the assessments. The learning unit will highlight varied professions ranging between physiotherapy, medicine, nursing, and occupational therapy and learners will be able to compare and contrast the definitions of clinical reasoning within said professions, as well as relate how this team-understanding fits into the broader picture of healthcare, with a goal to establish a common understanding and definition of 'clinical reasoning'.

Theme(s): (Interprofessional) Collaboration
Level: Novice
Format: Asynchronous preparatory phase (ca 45 min) followed by a synchronous meeting (ca. 90min)
Recommended ECTS: 0.08
Links: Student course - Facilitator resources

Using the Outcome Present State Test Model

This learning unit provides an introduction into the the Outcome-Presenter-State model for clinical reasoning, which is applied especially in nursing. The learning unit is designed for novices of all health professions who are at the beginning of their education.

Theme(s): Theories of Clinical Reasoning
Level: Novice
Format: Asynchronous preparation phase (ca. 80 min) with a follow-up synchronous meeting (ca. 90 min)
Recommended ECTS: 0.09
Links: Student course - Facilitator resources

Illness Scripts

This learning unit provides an introduction into scripts in general and more specifically into llness scripts for novices who are at the beginning of their education and do not have any prior knowledge or experience with illness scripts.

Theme(s): Theories of Clinical Reasoning
Level: Novice
Format: Two synchronous sessions (ca. 160 min) with an asynchronous learning phase (ca. 60 min) in between
Recommended ECTS: 0.12
Links: Student course - Facilitator resources

Dual Process Theory

This learning unit provides an introduction into the dual processing theory amd highlights the differences between system 1 and system 2 reasoning.

Theme(s): Theories of Clinical Reasoning
Level: Novice
Format: Asynchronous preparation phase (ca. 90 min) followed by a synchronous meeting (ca. 90 min)
Recommended ECTS: 0.1
Links: Student course - Facilitator resources

What is clinical reasoning and how can theories be put into practice

This learning unit covers how clinical reasoning theories can be used/applied during beside teaching, internships or other patient-centered situations and why it is important to know these theories. It deepens the differences and similarities of clinical reasoning in the health professions, terminology used and importance of clinical reasoning.

Theme(s): Theories of Clinical Reasoning
Level: Intermediate
Format: Asynchronous preparation (ca. 45 min) for a follow-up synchronous meeting (ca. 60 min)
Recommended ECTS: 0.07
Links: Student course - Facilitator resources

What is Clinical Reasoning - An Introduction

This learning unit provides an introduction into the topic for novices who are at the beginning of their education and do not have any prior knowledge or experiences with clinical reasoning.

Theme(s): Theories of Clinical Reasoning
Level: Novice
Format: Synchronous meeting (60 min) followed by asynchronous follow-up (60 min)
Recommended ECTS: 0.07
Links: Student course - Facilitator resources