Background: The Exercises in Clinical Reasoning (ECR) series in the Journal of General Internal Medicine (JGIM) is a unique and growing series of 30 case-based problem-solving manuscripts, designed to teach the foundations of clinical reasoning to both educators and students. For selected cases, the ECR team has produced teaching materials, including PowerPoints of ECR cases [...]

Background: High quality clinical documentation is essential for patient safety. Thoughtful clinical documentation transmits one’s clinical reasoning and is considered to be a professional responsibility. There are no accepted standards for assessing documentation with respect to clinical reasoning. We therefore undertook this study to establish a metric to evaluate hospitalists’ documentation of clinical reasoning in [...]

Case Presentation: A 83-year-old woman of Chinese origin with remote history of breast cancer and pulmonary fibrosis of unknown etiology presented to care with one month of fevers, night sweats, malaise, and cough. After three negative acid-fast bacillus (AFB) smears and CT chest showing chronic right apical scarring during hospital admission, she was discharged on [...]

Case Presentation: An 84-year-old man from China with a history of remote gastric cancer with prior subtotal gastrectomy, chronic hepatitis B virus infection on antivirals (without cirrhosis, normal liver function tests) was brought to the hospital after his family found him to be obtunded. At baseline he was independent in all iADLs. Physical exam showed [...]