Rethinking clinical reasoning: time for a dialogical turn.

Area of Science:

• Medical Education
• Philosophy of Medicine
• Cognitive Science

Background:

• Clinical reasoning is fundamental to medical practice and has been extensively researched.
• Current theoretical models of clinical reasoning have limitations in explanatory power.
• Existing models are often based on narrow assumptions about the nature of clinical reasoning.

Purpose of the Study:

• To explore diverse conceptualizations of clinical reasoning for a deeper understanding of clinical encounters.
• To propose a dialogical approach to clinical reasoning that integrates various theoretical frameworks.
• To highlight the role of language, including narrative, rhetoric, and metaphor, in clinical reasoning.

Main Methods:

• Conceptual analysis of existing theoretical models of clinical reasoning.
• Development of a dialogical framework for understanding clinical reasoning.
• Integration of insights from different theoretical perspectives on clinical reasoning.

Main Results:

• A dialogical approach provides a richer vocabulary for understanding clinical reasoning.
• Dialogism facilitates the integration of strengths from diverse theoretical frameworks.
• This approach emphasizes the complex use of language in generating meaning within clinical reasoning.

Conclusions:

• A dialogical approach enhances the understanding of clinical reasoning without discarding previous findings.
• It offers a means to integrate existing knowledge for more practical application in clinical settings.
• This framework promotes a more nuanced view of clinical reasoning, incorporating linguistic complexities.