• J Eval Clin Pract · Jun 2024

    Review

    The inseparability of context and clinical reasoning.

    • Andrew Olson, Juliane E Kämmer, Ahmed Taher, Robert Johnston, Qian Yang, Shawn Mondoux, and Sandra Monteiro.
    • Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
    • J Eval Clin Pract. 2024 Jun 1; 30 (4): 533538533-538.

    AbstractEarly 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.© 2024 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.

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