Embracing complexity with systems thinking in general practitioners' clinical reasoning helps handling uncertainty

Area of Science:

• General Practice
• Medical Education
• Systems Science

Background:

• Clinical reasoning faces challenges due to increasing patient multimorbidity.
• Unpredictable interactions between multiple conditions, patient personality, psychosocial context, and life history create diagnostic uncertainty.
• Current clinical reasoning education predominantly uses hypothetico-deductive reasoning.

Purpose of the Study:

• To propose systems thinking as a more appropriate paradigm for clinical reasoning in complex cases.
• To demonstrate the application and added value of systems thinking tools in general practice.
• To illustrate how complexity levels in clinical reasoning can be graded.

Main Methods:

• Utilizing systems thinking tools, specifically causal loop diagrams.
• Analyzing a case history to demonstrate the application of systems thinking.
• Grading complexity levels within clinical reasoning.

Main Results:

• Systems thinking provides a holistic view of patient problems.
• Causal loop diagrams facilitate understanding of complex interactions in multimorbidity.
• Systems thinking offers added value in managing complex clinical cases.

Conclusions:

• Systems thinking is a valuable approach for enhancing clinical reasoning in general practice, particularly for patients with multimorbidity.
• The application of systems thinking tools can improve the management of complex patient cases.
• Grading complexity and applying systems thinking are crucial for effective clinical decision-making.