• Erik Stolper, Van RoyenPaulPFaculty of Medicine and Health Sciences, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium., Edmund Jack, Jeroen Uleman, and Olde RikkertMarcelMDeptartment of Geriatric Medicine, Radboud University Medical Center, Nijmegen, Netherlands..
• Faculty of Health, Medicine and Life Sciences, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands.
• J Eval Clin Pract. 2021 Oct 1; 27 (5): 1175-1181.

AbstractClinical reasoning in general practice is increasingly challenging because of the rise in the number of patients with multimorbidity. This creates uncertainty because of unpredictable interactions between the symptoms from multiple medical problems and the patient's personality, psychosocial context and life history. Case analysis may then be more appropriately managed by systems thinking than by hypothetic-deductive reasoning, the predominant paradigm in the current teaching of clinical reasoning. Application of "systems thinking" tools such as causal loop diagrams allows the patient's problems to be viewed holistically and facilitates understanding of the complex interactions. We will show how complexity levels can be graded in clinical reasoning and demonstrate where and how systems thinking can have added value by means of a case history.© 2021 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.

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