Case-Based Clinical Reasoning And Decision Making

Abstract

Aim: We can define clinical reasoning as the ability to think and decide in clinical processes, which is non-reductive, multidimensional and free from prejudices. Clinical reasoning is a basic competence that a physician should have. In this article, theories about clinical reasoning, stages of clinical reasoning, training and evaluation methods, and the relationship between clinical reasoning and medical malpractice are discussed and related evidence is presented.Methods: The article was prepared by the traditional review methodResults: Non-analytical (system 1), analytical (system 2) thinking and dual process theories are accepted among the theories of how clinical reasoning is realized. Non-analytical thinking is an intuitive thinking that takes place fast and does not require much mental effort. Analytical thinking (system 2 thinking) is established by establishing a cause-effect relationship. In clinical reasoning, the stages of gathering information, forming hypothesis and testing hypothesis constitute a general framework. For clinical reasoning education, frameworks / models for this competence should be determined in educational activities, assessment and evaluation from the first years, and their use should be encouraged. Medical errors and inadequate clinical reasoning processes are related. For this reason, it is important to consider the clinical reasoning insufficiency areas in educational approaches. Clinical reasoning assessments should cover all stages of reasoning. Numerous methods and question / inquiry frameworks have been identified in the evaluation of clinical reasoning. In these, the basic principles are to ask questions that require reasoning with guides structured in accordance with the clinical reasoning stages.Conclusions: Clinical reasoning ability is the basic competence that a physician should have in order to ensure patient safety by reducing medical errors, to reduce unnecessary work and procedures in health, to prevent patient physician disputes and therefore violent events. Learning and assessment activities should be planned using models suitable for clinical reasoning terms and stages.