Understanding the process of clinical judgement for pharmacists when making clinical decisions

Clinical decision-making is arguably the most important and underappreciated skill in pharmacy. It can be described as four discrete steps: information gathering, clinical reasoning and judgement and, the decision process. The information gathering and decision negotiation steps and to some extent clinical reasoning are addressed either implicitly or explicitly by practitioners and educators. Clinical judgement, however, remains a largely unexplored concept for clinical decision-making in healthcare therapeutics. It defines how practitioners arrive at a favourable treatment strategy and, due to the often complicated benefit:risk evaluations, is often linked with concepts relating to ambiguity. In this article, we use game theory to explore the judgement stage of clinical decision-making. Game theory allows us to provide a quantitative evaluation of clinical judgement and explore concepts such as ambiguity and its sources in healthcare. Clarifying the elements involved in the judgement stage of clinical decision-making will enable a better understanding of how pharmacists contribute patient care in healthcare teams.