Introduction: Oral presentations of clinical cases are the main activities of medical students. This educational moment of exchange with the clinical teacher is crucial for the development of their clinical reasoning. However, these presentations are very often focused solely on resolving the clinical case to the detriment of supporting the development of students’ clinical reasoning. The present study aims to explore the issues relating to the expression of clinical reasoning in the use of the usual case discussion method.

Methods: Mixed descriptive and analytical pilot study. We analyzed the transcription of oral presentations of “classic” cases, in terms of the expression of each stage of the clinical reasoning. We used the Bordage Diagnostic Thinking Inventory (DTI) instrument for the quantitative analysis of clinical reasoning.

Results: Eight oral case presentations were collected. Our main results demonstrated that the initial problem representation stage was adequate, with good data collection. However, the generation of hypotheses was rarely formulated and argued. As for complementary tests, they were sometimes requested before generating hypotheses. Finally, the synthesis of the clinical situation and the problem was not clearly formulated. Regarding the DTI, the average score for flexibility of thinking was 92 ± 9 and the score for structuring memory is 93 ± 6.

Conclusion: The usual method of case discussion too often remains focused on a succession of facts and information and does not sufficiently promote the explanation of clinical reasoning at all its stages.