The inseparability of context and clinical reasoning.

Olson, Andrew; Kämmer, Juliane E; Taher, Ahmed; Johnston, Robert; Yang, Qian; Mondoux, Shawn; Monteiro, Sandra (2024). The inseparability of context and clinical reasoning. Journal of evaluation in clinical practice, 30(4), pp. 533-538. Wiley-Blackwell 10.1111/jep.13969

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Early descriptions of clinical reasoning have described a dual process model that relies on analytical or nonanalytical approaches to develop a working diagnosis. In this classic research, clinical reasoning is portrayed as an individual-driven cognitive process based on gathering information from the patient encounter, forming mental representations that rely on previous experience and engaging developed patterns to drive working diagnoses and management plans. Indeed, approaches to patient safety, as well as teaching and assessing clinical reasoning focus on the individual clinician, often ignoring the complexity of the system surrounding the diagnostic process. More recent theories and evidence portray clinical reasoning as a dynamic collection of processes that takes place among and between persons across clinical settings. Yet, clinical reasoning, taken as both an individual and a system process, is insufficiently supported by theories of cognition based on individual clinicals and lacks the specificity needed to describe the phenomenology of clinical reasoning. In this review, we reinforce that the modern healthcare ecosystem - with its people, processes and technology - is the context in which health care encounters and clinical reasoning take place.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center

UniBE Contributor:

Kämmer, Juliane Eva

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1365-2753

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Pubmed Import

Date Deposited:

05 Feb 2024 14:33

Last Modified:

25 May 2024 00:12

Publisher DOI:

10.1111/jep.13969

PubMed ID:

38300231

Uncontrolled Keywords:

clinical guidelines diagnostic reasoning system dynamics

BORIS DOI:

10.48350/192351

URI:

https://boris.unibe.ch/id/eprint/192351

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