Clinical Reasoning

• Clinical reasoning:

  • a reflective process of enquiry and analysis carried out by health professional in collaboration with the patient with the aim of understanding the patient, the patient’s context and the patient’s clinical problem in order to guide evidence based practice - (Brooker, 2013)
• Consider the person:

  • who the person is
  • why they have come
  • their goals and expectation
  • their work life
  • their social life
  • their behaviours and general lifestyle

  
• Core elements of clinical reasoning - knowledge:

  • Healthy individual – anatomy, physiology, biomechanics
  • Unhealthy – pathology, psychosocial, vocational etc
  • Pain, guidelines, clinical prediction rules etc.
• Core elements of clinical reasoning - Cognition:

  • Problem formulation and setting
  • Perception, evaluation, analysis
• Core elements of clinical reasoning -Metacognition:

  • Self evaluation
  • Review of knowledge
  • Self criticism
• Effective clinical reasoning - Therapist attributes:

  • knowledge
  • experience with the type of case being managed
  • reasoning proficiency
  • communication and teaching skills etc.
• Effective clinical reasoning - Patient attributes:

  • needs
  • attitudes
  • communication skills
  • willingness to engage
• Effective clinical reasoning - Environment attributes:

  • resources
  • time
  • funding