{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T12:33:07Z","timestamp":1793622787820,"version":"4.5.0"},"reference-count":52,"publisher":"Elsevier BV","issue":"11","license":[{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.fr","em-consulte.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["La Revue de M\u00e9decine Interne"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1016\/j.revmed.2026.08.014","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T11:15:20Z","timestamp":1789557320000},"page":"611-616","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Une formation structur\u00e9e des m\u00e9decins au raisonnement clinique et \u00e0 la prise de d\u00e9cision a un impact favorable sur la qualit\u00e9 des soins"],"prefix":"10.1016","volume":"47","author":[{"given":"Etienne","family":"Rivi\u00e8re","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.revmed.2026.08.014_bib0265","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.revmed.2022.10.387","article-title":"Faire de la tol\u00e9rance \u00e0 l\u2019incertitude une comp\u00e9tence m\u00e9dicale","volume":"44","author":"Belhomme","year":"2023","journal-title":"Rev Med Interne"},{"key":"10.1016\/j.revmed.2026.08.014_bib0270","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.revmed.2010.10.009","article-title":"Les activit\u00e9s mentales au cours du raisonnement m\u00e9dical diagnostique","volume":"32","author":"Pottier","year":"2011","journal-title":"Rev Med Interne"},{"key":"10.1016\/j.revmed.2026.08.014_bib0275","series-title":"Med. Inform. Comput. Appl. Health Care Biomed.","article-title":"Medical decision-making: probabilistic medical reasoning","author":"Owens","year":"2001"},{"key":"10.1016\/j.revmed.2026.08.014_bib0280","doi-asserted-by":"crossref","first-page":"l4185","DOI":"10.1136\/bmj.l4185","article-title":"Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis","volume":"366","author":"Panagioti","year":"2019","journal-title":"BMJ"},{"key":"10.1016\/j.revmed.2026.08.014_bib0285","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2020-045948D","article-title":"Diagnostic error in pediatrics: a narrative review","volume":"149","author":"Marshall","year":"2022","journal-title":"Pediatrics"},{"key":"10.1016\/j.revmed.2026.08.014_bib0290","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1001\/archinte.165.13.1493","article-title":"Diagnostic error in internal medicine","volume":"165","author":"Graber","year":"2005","journal-title":"Arch Intern Med"},{"key":"10.1016\/j.revmed.2026.08.014_bib0295","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1001\/archinternmed.2009.333","article-title":"Diagnostic error in medicine: analysis of 583\u00a0physician-reported errors","volume":"169","author":"Schiff","year":"2009","journal-title":"Arch Intern Med"},{"key":"10.1016\/j.revmed.2026.08.014_bib0300","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1515\/dx-2019-0019","article-title":"Serious misdiagnosis-related harms in malpractice claims: The \u201cBig Three\u201d\u00a0\u2013\u00a0vascular events, infections, and cancers","volume":"6","author":"Newman-Toker","year":"2019","journal-title":"Diagnosis"},{"key":"10.1016\/j.revmed.2026.08.014_bib0305","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s10459-009-9194-y","article-title":"Cognitive elements in clinical decision-making: toward a cognitive model for medical education and understanding clinical reasoning","volume":"15","author":"Dunphy","year":"2010","journal-title":"Adv Health Sci Educ Theory Pract"},{"key":"10.1016\/j.revmed.2026.08.014_bib0310","doi-asserted-by":"crossref","first-page":"979","DOI":"10.2147\/IJWH.S442977","article-title":"Proactive coping in early pregnancy and adverse pregnancy outcomes","volume":"16","author":"Cersonsky","year":"2024","journal-title":"Int J Womens Health"},{"key":"10.1016\/j.revmed.2026.08.014_bib0315","series-title":"The CanMEDS 2005\u00a0physician competency framework: better standards \u2013\u00a0better physicians\u00a0\u2013 better care","year":"2006"},{"key":"10.1016\/j.revmed.2026.08.014_bib0320","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1051\/pmed\/2022031","article-title":"Favoriser le d\u00e9veloppement du raisonnement clinique des \u00e9tudiants en m\u00e9decine\u00a0: une d\u00e9marche d\u2019am\u00e9lioration","volume":"23","author":"Cleverley-Leblanc","year":"2022","journal-title":"P\u00e9dagogie Med"},{"key":"10.1016\/j.revmed.2026.08.014_bib0325","unstructured":"Current State of Diagnosis Education. Content last reviewed March 2022. Agency for Healthcare Research and Quality, Rockville, MD. https:\/\/www.ahrq.gov\/diagnostic-safety\/resources\/issue-briefs\/education-dx-outcomes-3.html n.d."},{"key":"10.1016\/j.revmed.2026.08.014_bib0330","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1051\/pmed\/2020016","article-title":"Des pratiques \u00e9ducatives fond\u00e9es sur les opinions aux pratiques \u00e9ducatives fond\u00e9es sur les preuves","volume":"20","author":"Pelaccia","year":"2019","journal-title":"P\u00e9dagogie Med"},{"key":"10.1016\/j.revmed.2026.08.014_bib0335","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1136\/ebm.13.4.98-a","article-title":"Knowledge-to-action cycle","volume":"13","author":"Straus","year":"2008","journal-title":"BMJ Evid Based Med"},{"key":"10.1016\/j.revmed.2026.08.014_bib0340","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.revmed.2010.12.005","article-title":"\u00c9ducation et qualit\u00e9 de la d\u00e9cision m\u00e9dicale\u00a0: un lien fond\u00e9 sur des preuves existe-t-il\u00a0?","volume":"32","author":"Nendaz","year":"2011","journal-title":"Rev Med Interne"},{"key":"10.1016\/j.revmed.2026.08.014_bib0345","article-title":"Clinical reasoning curricula in health professions education: a scoping review","volume":"10","author":"Elv\u00e9n","year":"2023","journal-title":"J Med Educ Curric Dev"},{"key":"10.1016\/j.revmed.2026.08.014_bib0350","doi-asserted-by":"crossref","first-page":"e0309606","DOI":"10.1371\/journal.pone.0309606","article-title":"Teaching and learning clinical reasoning skill in undergraduate medical students: a scoping review","volume":"19","author":"Delavari","year":"2024","journal-title":"PLoS One"},{"key":"10.1016\/j.revmed.2026.08.014_bib0355","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1177\/1062860616681626","article-title":"Education for the next frontier in patient safety: a longitudinal resident curriculum on diagnostic error","volume":"32","author":"Ruedinger","year":"2017","journal-title":"Am J Med Qual"},{"key":"10.1016\/j.revmed.2026.08.014_bib0360","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1007\/s10459-025-10412-z","article-title":"Using clinical cases with diagnostic errors and malpractice claims: impact on anxiety and diagnostic performance in GP clinical reasoning education","volume":"30","author":"van Sassen","year":"2025","journal-title":"Adv Health Sci Educ"},{"key":"10.1016\/j.revmed.2026.08.014_bib0365","doi-asserted-by":"crossref","first-page":"147","DOI":"10.7861\/fhj.2022-0120","article-title":"Shared decision-making training in general practice: a rapid review","volume":"10","author":"Nyamapfene","year":"2023","journal-title":"Future Healthc J"},{"key":"10.1016\/j.revmed.2026.08.014_bib0370","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1007\/s40596-016-0608-x","article-title":"Teaching medical ethics in graduate and undergraduate medical education: a systematic review of effectiveness","volume":"41","author":"de la Garza","year":"2017","journal-title":"Acad Psychiatry"},{"key":"10.1016\/j.revmed.2026.08.014_bib0375","first-page":"175","article-title":"Effectiveness of medical ethics education: a systematic review","volume":"10","author":"Moreira","year":"2021","journal-title":"MedEdPublish (2016)"},{"key":"10.1016\/j.revmed.2026.08.014_bib0380","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1186\/s12910-025-01329-8","article-title":"Outcomes of team based learning in teaching medical ethics: a systematic review","volume":"26","author":"Alizadeh","year":"2025","journal-title":"BMC Med Ethics"},{"key":"10.1016\/j.revmed.2026.08.014_bib0385","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1186\/s12910-021-00676-6","article-title":"Does teaching medical ethics ensure good knowledge, attitude, and reported practice? An ethical vignette-based cross-sectional survey among doctors in a tertiary teaching hospital in Nepal","volume":"22","author":"Shrestha","year":"2021","journal-title":"BMC Med Ethics"},{"key":"10.1016\/j.revmed.2026.08.014_bib0390","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1177\/10499091221084675","article-title":"Improving knowledge, attitudes, and skills of medical clinicians and trainees in clinical medical ethics","volume":"39","author":"Ali","year":"2022","journal-title":"Am J Hosp Palliat Care"},{"key":"10.1016\/j.revmed.2026.08.014_bib0395","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s12910-022-00766-z","article-title":"Ethics education to support ethical competence learning in healthcare: an integrative systematic review","volume":"23","author":"Andersson","year":"2022","journal-title":"BMC Med Ethics"},{"key":"10.1016\/j.revmed.2026.08.014_bib0400","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1093\/fampra\/cmh402","article-title":"Patient-based outcome results from a cluster randomized trial of shared decision making skill development and use of risk communication aids in general practice","volume":"21","author":"Edwards","year":"2004","journal-title":"Fam Pract"},{"key":"10.1016\/j.revmed.2026.08.014_bib0405","doi-asserted-by":"crossref","first-page":"967750","DOI":"10.3389\/fpsyt.2022.967750","article-title":"Implementation of a shared decision-making training program for clinicians based on the major depressive disorder guidelines in Japan: a multi-center cluster randomized trial","volume":"13","author":"Takaesu","year":"2022","journal-title":"Front Psychiatry"},{"key":"10.1016\/j.revmed.2026.08.014_bib0410","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1186\/s12909-024-05557-1","article-title":"A systematic review of shared decision making training programs for general practitioners","volume":"24","author":"Jaeken","year":"2024","journal-title":"BMC Med Educ"},{"key":"10.1016\/j.revmed.2026.08.014_bib0415","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1016\/j.pec.2019.12.016","article-title":"Educational programs to teach shared decision making to medical trainees: a systematic review","volume":"103","author":"Singh Ospina","year":"2020","journal-title":"Patient Educ Couns"},{"key":"10.1016\/j.revmed.2026.08.014_bib0420","doi-asserted-by":"crossref","first-page":"107712","DOI":"10.1016\/j.pec.2023.107712","article-title":"A blended learning for general practitioners and nurses on skills to support shared decision-making with patients about palliative cancer treatment: a one-group pre-posttest study","volume":"112","author":"Bos\u00a0\u2013\u00a0van den Hoek","year":"2023","journal-title":"Patient Educ Couns"},{"key":"10.1016\/j.revmed.2026.08.014_bib0425","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1177\/0272989X231203693","article-title":"Through the eyes of patients: the effect of training general practitioners and nurses on perceived shared decision-making support","volume":"44","author":"Bos\u00a0\u2013\u00a0van den Hoek","year":"2024","journal-title":"Med Decis Making"},{"key":"10.1016\/j.revmed.2026.08.014_bib0430","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1007\/s10459-019-09896-3","article-title":"Incorporating content related to value and cost-considerations in clinical decision-making: enhancements to medical education","volume":"24","author":"Manja","year":"2019","journal-title":"Adv Health Sci Educ Theory Pract"},{"key":"10.1016\/j.revmed.2026.08.014_bib0435","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1080\/10401334.2013.857335","article-title":"Critical thinking in health professions education: summary and consensus statements of the Millennium Conference 2011","volume":"26","author":"Huang","year":"2014","journal-title":"Teach Learn Med"},{"key":"10.1016\/j.revmed.2026.08.014_bib0440","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1017\/S0963180114000061","article-title":"The ethical imperative to think about thinking\u00a0\u2013\u00a0diagnostics, metacognition, and medical professionalism","volume":"23","author":"Stark","year":"2014","journal-title":"Camb Q Healthc Ethics"},{"key":"10.1016\/j.revmed.2026.08.014_bib0445","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1136\/medethics-2014-102302","article-title":"What is good medical ethics? A clinician's perspective","volume":"41","author":"Kong","year":"2015","journal-title":"J Med Ethics"},{"key":"10.1016\/j.revmed.2026.08.014_bib0450","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1080\/0142159X.2020.1842343","article-title":"Consensus statement on the content of clinical reasoning curricula in undergraduate medical education","volume":"43","author":"Cooper","year":"2021","journal-title":"Med Teach"},{"key":"10.1016\/j.revmed.2026.08.014_bib0455","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1080\/0142159X.2022.2105200","article-title":"Implementation of three knowledge-oriented instructional strategies to teach clinical reasoning: Self-explanation, a concept mapping exercise, and deliberate reflection: AMEE Guide No. 150","volume":"45","author":"Torre","year":"2023","journal-title":"Med Teach"},{"key":"10.1016\/j.revmed.2026.08.014_bib0460","doi-asserted-by":"crossref","first-page":"145","DOI":"10.3946\/kjme.2024.292","article-title":"Teaching clinical reasoning: principles from the literature to help improve instruction from the classroom to the bedside","volume":"36","author":"Durning","year":"2024","journal-title":"Korean J Med Educ"},{"key":"10.1016\/j.revmed.2026.08.014_bib0465","doi-asserted-by":"crossref","first-page":"e436","DOI":"10.3109\/01421591003695303","article-title":"Teaching for clinical reasoning - helping students make the conceptual links","volume":"32","author":"McMillan","year":"2010","journal-title":"Med Teach"},{"key":"10.1016\/j.revmed.2026.08.014_bib0470","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/medu.14863","article-title":"Deliberate reflection and clinical reasoning: founding ideas and empirical findings","volume":"57","author":"Mamede","year":"2023","journal-title":"Med Educ"},{"key":"10.1016\/j.revmed.2026.08.014_bib0475","doi-asserted-by":"crossref","first-page":"334","DOI":"10.4300\/JGME-D-14-00601.1","article-title":"Can think aloud be used to teach and assess clinical reasoning in graduate medical education?","volume":"7","author":"Pinnock","year":"2015","journal-title":"J Grad Med Educ"},{"key":"10.1016\/j.revmed.2026.08.014_bib0480","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1097\/ACM.0000000000000362","article-title":"SNAPPS-Plus: an educational prescription for students to facilitate formulating and answering clinical questions","volume":"89","author":"Nixon","year":"2014","journal-title":"Acad Med"},{"key":"10.1016\/j.revmed.2026.08.014_bib0485","first-page":"419","article-title":"A five-step \u201cmicroskills\u201d model of clinical teaching","volume":"5","author":"Neher","year":"1992","journal-title":"J Am Board Fam Pract"},{"key":"10.1016\/j.revmed.2026.08.014_bib0490","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1186\/s12909-023-04541-5","article-title":"Deliberate practice of diagnostic clinical reasoning reveals low performance and improvement of diagnostic justification in pre-clerkship students","volume":"23","author":"Staal","year":"2023","journal-title":"BMC Med Educ"},{"key":"10.1016\/j.revmed.2026.08.014_bib0495","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.5334\/pme.1986","article-title":"How and when should clinical reasoning be taught in undergraduate medicine: a systematic review and meta-analyses","volume":"14","author":"Wark","year":"2025","journal-title":"Perspect Med Educ"},{"key":"10.1016\/j.revmed.2026.08.014_bib0500","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1136\/bmj.326.7389.591","article-title":"Learning and teaching in the clinical environment","volume":"326","author":"Spencer","year":"2003","journal-title":"BMJ"},{"key":"10.1016\/j.revmed.2026.08.014_bib0505","doi-asserted-by":"crossref","DOI":"10.1186\/s12909-026-09931-z","article-title":"A systematic review of the current challenges of bedside teaching for medical students in the UK","author":"Chukwudi","year":"2026","journal-title":"BMC Med Educ"},{"key":"10.1016\/j.revmed.2026.08.014_bib0510","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1007\/S40037-013-0083-Y","article-title":"Bedside teaching in medical education: a literature review","volume":"3","author":"Peters","year":"2013","journal-title":"Perspect Med Educ"},{"key":"10.1016\/j.revmed.2026.08.014_bib0515","doi-asserted-by":"crossref","first-page":"S41","DOI":"10.1046\/j.1525-1497.12.s2.6.x","article-title":"What if Osler were one of us?","volume":"12","author":"Ende","year":"1997","journal-title":"J Gen Intern Med"},{"key":"10.1016\/j.revmed.2026.08.014_bib0260","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1186\/s12909-021-02960-w","article-title":"Why is it so difficult to implement a longitudinal clinical reasoning curriculum? A multicenter interview study on the barriers perceived by European health professions educators","volume":"21","author":"Sudacka","year":"2021","journal-title":"BMC Med Educ"}],"container-title":["La Revue de M\u00e9decine Interne"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0248866326007241?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0248866326007241?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T12:22:05Z","timestamp":1793622125000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0248866326007241"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,11]]},"references-count":52,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["S0248866326007241"],"URL":"https:\/\/doi.org\/10.1016\/j.revmed.2026.08.014","relation":{},"ISSN":["0248-8663"],"issn-type":[{"value":"0248-8663","type":"print"}],"subject":[],"published":{"date-parts":[[2026,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Une formation structur\u00e9e des m\u00e9decins au raisonnement clinique et \u00e0 la prise de d\u00e9cision a un impact favorable sur la qualit\u00e9 des soins","name":"articletitle","label":"Article Title"},{"value":"La Revue de M\u00e9decine Interne","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.revmed.2026.08.014","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Soci\u00e9t\u00e9 Nationale Fran\u00e7aise de M\u00e9decine Interne (SNFMI). Published by Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}