Table 6.

The shortcomings of reasoning ability in long station by group history-taking with individual reasoning.

School year	2019	2020 and 2022	2021
Topics:	Fever	Abdominal pain	Body weight loss
Shortcomings of chief complaint	The time is not described. Describe too many other symptoms.	The time is not described. Describe too many other symptoms.	The time and reduced weight are not described. Describe too many other symptoms.
Shortcomings of problem representation	Lack of detail such as: fever (up to 39°C), (dry) cough, (safe) sex, (left) flank pain	Easy to ignore negative information such as: no skin herpes zoster, no diarrhea	Easy to ignore negative information such as: no fever, normal urination
Shortcomings of differential diagnosis and Diagnostic justification	1. The students cannot differentiate these GU diseases including urinary tract stone, UTI, (acute) pyelonephritis, (acute) nephritis, kidney trauma, PID, flank sprain. 2. The students cannot differentiate these GI diseases including IBS, acute appendicitis, AGE, acute cholecystitis, infectious diarrhea, intra-abdominal infection. 3. The students cannot differentiate lung diseases including URI, influenza, TB infection.	1. The students cannot differentiate GI diseases including (acute or chronic) pancreatitis, (acute or chronic) cholangitis and (acute or chronic) cholecystitis. 2. The students were unclear when to order the exams including plain abdomen, abdominal echo, abdominal CT, ERCP, MRCP, and PTCD. 3. The students were unclear how to order the correct liver function tests.	1. The students were unclear about how to diagnose hyperthyroidism, and the correlations between weight loss and DM with poor control. 2. The students knew weight loss is correlated with lung or thyroid CA, and wanted to prove by CT, MRI, or PET. 3. There were other diagnoses for SOB and palpitation such as arrhythmia, ACS, heart failure, TB, stress, depression, or anxiety

IBS: irritable bowel syndrome; ACS: acute coronary syndrome.