A concise guide to clinical reasoning

Area of Science:

• Medical Education
• Philosophy of Medicine
• Cognitive Science

Background:

• Clinical reasoning is complex, with ongoing debate about diagnosis, data use (patient-specific vs. population-based), and the role of virtue in expertise.
• Existing models may not fully integrate the multifaceted aspects of clinical decision-making.

Purpose of the Study:

• To present a novel model of clinical reasoning.
• To integrate the processes of diagnosis, prognosis, and therapeutic decision-making.
• To provide a methodical framework for studying clinical reasoning and related concepts.

Main Methods:

• The study employs Bernard Lonergan's generalized empirical method, emphasizing both the investigator (subject) and the subject matter (object).
• It identifies structured operations of knowing and doing, linking them to a self-correcting learning cycle.
• Correlates levels of inquiry (what-is-going-on, what-to-do) with practical and theoretical elements of clinical reasoning.

Main Results:

• A comprehensive model of clinical reasoning is proposed, unifying diagnosis, prognosis, and treatment.
• The model highlights the interplay between theoretical knowledge and practical application in healthcare.
• It establishes a framework for analyzing the components of clinical expertise and virtuous practice.

Conclusions:

• The proposed model offers a systematic method for investigating clinical reasoning processes.
• It provides a foundation for understanding the nature of clinical data, expertise, and ethical healthcare.
• This framework can advance research into improving diagnostic accuracy and therapeutic decision-making.