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Clinical reasoning - a guide to improving teaching and practice
Andrew Linn1, Carole Khaw, Hugh Kildea
1Clinical Education, Medicine Learning and Teaching Unit, The University of Adelaide, South Australia. andrew.linn@adelaide.edu.au
Background:
The process of clinical reasoning is undertaken by all clinicians, often automatically, and is the cognitive process that underlies diagnosis and management of a patient's presenting problem. The teaching of clinical reasoning can pose a challenge to the clinical teacher.
Objective:
This article reviews the process of clinical reasoning and provides the teacher with a framework to teach clinical reasoning to students and junior doctors.
Discussion:
By considering clinical reasoning as a skill to be learnt rather than a concept to be understood, a framework for teaching this skill can be developed. The learner initially observes a consultation by the teaching clinician, followed by the teacher explaining the reasoning processes used including hypothesising, hypothesis testing, re-analysis and differential diagnosis. The student then comments on the reasoning of the teacher in a subsequent consultation, followed by feedback from the teacher on the student's reasoning in a third consultation.
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