Clinical reasoning is a fundamental process used by healthcare professionals, including doctors, nurses, and other medical practitioners, to analyze patient information, make diagnoses, and develop treatment plans. It involves critical thinking, problem-solving, and the application of medical knowledge to provide the best possible care to patients. Here are the basics of clinical reasoning:

Data Gathering: The first step in clinical reasoning is gathering relevant information about the patient’s medical history, symptoms, physical examination findings, and any diagnostic test results. This process involves active listening, effective communication with the patient, and using appropriate questioning techniques.

Recognizing Patterns: Healthcare professionals must recognize patterns and identify potential relationships between the patient’s signs and symptoms. This involves comparing the patient’s presentation to known medical conditions and recognizing typical and atypical presentations.

"Clinical reasoning is the cognitive processing and decision-making surrounding healthcare practice" Thiani & Mershen (2023)

Generate Hypotheses: Based on the gathered data and pattern recognition, clinicians generate possible diagnoses or hypotheses. These hypotheses guide further investigation and are essential for the diagnostic process.

Differential Diagnosis: Healthcare professionals consider a list of potential diagnoses, known as a differential diagnosis. This list ranks possible explanations for the patient’s condition from most to least likely based on available evidence.

Prioritization: After generating a differential diagnosis, clinicians prioritize the potential conditions based on their severity, urgency, and impact on the patient’s health. This helps in identifying the most critical issues that need immediate attention.

Further Testing: To confirm or rule out the hypotheses, additional diagnostic tests or examinations may be ordered. These tests could include laboratory tests, imaging studies, or consultations with other specialists.

Evaluation: The results of the tests are evaluated, and clinicians compare them to the expected findings for each potential diagnosis. This evaluation helps in refining the differential diagnosis and narrowing down the possible conditions.

Diagnosis: Using all available information, including the patient’s history, examination findings, test results, and clinical expertise, the healthcare professional arrives at a final diagnosis. This is the identification of the underlying medical condition responsible for the patient’s symptoms.

Treatment Plan: Once the diagnosis is established, a treatment plan is developed. This may include medications, procedures, lifestyle changes, or referrals to specialists for further management.

Monitoring and Reevaluation: Healthcare professionals continuously monitor the patient’s response to treatment and adjust the management plan as needed. Reevaluation is crucial if the patient’s condition changes or if new information becomes available.

Reflection and Learning: Clinical reasoning is an ongoing process, and healthcare professionals reflect on their decisions and outcomes to learn and improve their skills continuously.

Clinical reasoning requires a balance between theoretical medical knowledge, practical experience, and critical thinking skills. It is an essential aspect of providing high-quality and patient-centered care in the medical field.

References

Pillay, T., & Pillay, M. (2023). The power struggle: exploring the reality of clinical reasoning. Health: An Interdisciplinary Journal for the Social Study of Health, Illness & Medicine, 27(4), 559–587. https://doi-org.proxy.mul.missouri.edu/10.1177/13634593211054008

Trinidad, D. R., & Wung, S.-F. (2023). Excellence via Strategic Experiential Learning (ExSEL): A Continuous Improvement Project for Developing Clinical Reasoning and Management. Clinical Simulation in Nursing, 81, N.PAG. https://doi-org.proxy.mul.missouri.edu/10.1016/j.ecns.2023.05.003

van Sassen, C. G. M., van den Berg, P. J., Mamede, S., Knol, L., Eikens-Jansen, M. P., van den Broek, W. W., Bindels, P. J. E., & Zwaan, L. (2023). Identifying and prioritizing educational content from a malpractice claims database for clinical reasoning education in the vocational training of general practitioners. Advances in Health Sciences Education, 28(3), 893–910. https://doi-org.proxy.mul.missouri.edu/10.1007/s10459-022-10194-8