What every teacher needs to know about clinical reasoning

Authors

  • Kevin W Eva

    1. Program for Educational Research and Development, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
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Kevin W Eva, Program for Educational Research and Development, Department of Clinical Epidemiology and Biostatistics, MDCL 3522, McMaster University, Hamilton, Ontario L8N 3Z5, Canada. Tel: 00 1 905 525 9140 ext. 27241; Fax: 00 1 905 572 7099;
E-mail: evakw@mcmaster.ca.

Abstract

Context  One of the core tasks assigned to clinical teachers is to enable students to sort through a cluster of features presented by a patient and accurately assign a diagnostic label, with the development of an appropriate treatment strategy being the end goal. Over the last 30 years there has been considerable debate within the health sciences education literature regarding the model that best describes how expert clinicians generate diagnostic decisions.

Purpose  The purpose of this essay is to provide a review of the research literature on clinical reasoning for frontline clinical teachers. The strengths and weaknesses of different approaches to clinical reasoning will be examined using one of the core divides between various models (that of analytic (i.e. conscious/controlled) versus non-analytic (i.e. unconscious/automatic) reasoning strategies) as an orienting framework.

Discussion  Recent work suggests that clinical teachers should stress the importance of both forms of reasoning, thereby enabling students to marshal reasoning processes in a flexible and context-specific manner. Specific implications are drawn from this overview for clinical teachers.

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