People around the world who work in the medical field need to have many skills to decide how to deal with or manage a patient’s case. There are many skills and the clinical reasoning is one of them, and this essay will define clinical reasoning, its main models, and compare them to each other.
“Clinical Reasoning is the process by which a therapist interacts with a patient, collecting information, generating and testing hypotheses, and determining optimal diagnosis and treatment based on the information obtained.”1 Clinical reasoning is very important for therapists because they have to make a quick and critical decisions when they face a patient’s problems. At the beginning of their residency doctors may do wrong decisions and may do errors. “Clinical reasoning should begin as soon as the therapist meets the patient as their behavior can inform the therapists clinical reasoning.”1 There should be enough data collection that must not stop at the end of the assessment to aid this process. 1
To make a good decision there are many models for the process of clinical reasoning. 3 The first model is knowledge- reasoning integration. 3 It is the incorporation of mutual decision making process with the patient. 3 It occurs in stages, and it also involves three main elements (knowledge, cognition, metacognition). The first element is knowledge, normally people acquire their knowledge from life, and also, they acquire it from the school. 3 The second one is cognition, which is the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses. 2,3 And the third element is metacognition, which is the awareness or the understanding of the therapist’s own thought process. 2 The second model is the integrated patient-centered model. 3 In this model at the initial encounter with the patient, the therapist will ask them and talk with them to have a critical clinical reasoning. 3 As the first model has elements this model has also many elements that have to be consider of. 2 (Cognition, metacognition, the clinical problem, knowledge, the environment, and the client’s input) these are the elements of the integrated patient-centered model. 2,3 After taking care of the elements the understanding of the patient and the clinical problem will grow effectively to help the therapist find the perfect treatment plan. 2,3 Hypothetico-deductive reasoning is the last model we will talk about. 3 It is the process of generating a limited number of hypotheses early in the encounter and using them to guide the subsequent data collection. 3 “What this model adds to the previous knowledge was that in contrast to the traditional understanding that recommended we should first gather extensive information of the patients through a complete history and physical exam, and generate a list of differential diagnoses (13), hypothesis generation is an early event in the diagnostic reasoning process.” 3
To sum up, clinical reasoning is a very important skill that every therapist should have to let them make the perfect decisions to help their patient in progressing their treatment plan. And sometime clinical reasoning might not be that much able to be thought in schools more than it could be acquired from practicing it in the medical life.
1. 1 Physiopedia. Clinical reasoning. 2017cited December 16, 2017
available from: https://www.physio-pedia.com/Clinical_Reasoning#Process_of_Clinical_Reasoning
2. 2 School of Nursing and Midwifery Faculty of Health, University of Newcastle. Clinical reasoning. 2009cited December 16, 2017
available from: http://www.utas.edu.au/__data/assets/pdf_file/0003/263487/Clinical-Reasoning-Instructor-Resources.pdf
3. 3 NCBI. Models of clinical reasoning.2017cited December 16, 2017
available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5611427/