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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

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Published on: January 15, 2017

Thinking about thinking: implications for patient safety.

Kathryn Montgomery¹

¹Northwestern University's Feinberg School of Medicine, Chicago, Illinois, USA.

Healthcare Quarterly (Toronto, Ont.)

|August 12, 2009

Summary

This summary is machine-generated.

Physicians use practical reasoning, or phronesis, not strict scientific methods, for clinical judgment. Understanding this practical rationality, which relies on case narratives and experience, is key to improving medical practice.

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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

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Last Updated: Jun 21, 2026

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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Published on: February 16, 2011

Area of Science:

Philosophy of Medicine
Clinical Epistemology
Medical Education

Background:

Clinical medicine is often mislabeled as a pure science.
Physicians employ analogical and interpretive reasoning (phronesis) rather than purely scientific (episteme) methods.
Clinical judgment, a form of phronesis, depends on knowledge and experience but is not easily taught.

Purpose of the Study:

To explore the nature of clinical reasoning and judgment in medicine.
To highlight the importance of practical rationality and case narratives in medical practice.
To question why the epistemology of medicine is not formally taught.

Main Methods:

Analysis of the nature of clinical reasoning, contrasting scientific reasoning with practical reasoning (phronesis).
Examination of the role of case narratives in medical knowledge acquisition and communication.
Discussion of the tension between anecdotal evidence and scientific data in clinical practice.

Main Results:

Physicians' thinking is characterized by practical reasoning (phronesis), which involves integrating patient particulars with general medical knowledge.
Case narratives are crucial for learning, communication, and memory in clinical practice.
Evidence-based medicine complements, but cannot replace, clinical judgment.

Conclusions:

Clinical judgment is the core intellectual strength of clinicians, rooted in practical rationality.
Misunderstanding physicians' reasoning as purely scientific leads to perfectionism and fear of errors.
Teaching the epistemology of medicine could help clinicians better understand and value their practical reasoning skills.