• Gunver S Kienle and Helmut Kiene.
• Institute for Applied Epistemology and Medical Methodology, Freiburg i.Br., Germany. gunver.kienle@ifaemm.de
• J Eval Clin Pract. 2011 Aug 1; 17 (4): 621627621-7.

ObjectivesClinical judgment is a central element of the medical profession, essential for the performance of the doctor, and potentially generating information also for other clinicians and for scientists and health care managers. The recently renewed interest in clinical judgement is primarily engaged with its role in communication, diagnosis and decision making. Beyond this issue, the present article highlights the interrelations between clinical judgement, therapy assessment and medical professionalism.MethodsLiterature review and theory development.ResultsThe article presents different methodological approaches to causality assessment in clinical studies and in clinical judgement, and offers criteria for clinical single case causality. The article outlines models of medical professionalism such as technical rationality and practice epistemology, and characterizes features of professional expertise such as tacit knowledge, reflection in action, and gestalt cognition.ConclusionsConsequences of a methodological and logistical advancement of clinical judgment are discussed, both in regard to medical progress and to the renewal of the cognitive basis of the medical profession.© 2010 Blackwell Publishing Ltd.

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