Clinical reasoning is the cognitive process underlying diagnosis and management of patient problems. It involves integrating different types of knowledge, weighing evidence, critically thinking about arguments, and reflecting on the process used to arrive at a diagnosis. Developing clinical reasoning requires practicing skills and knowledge, using reflection, and employing strategies like using a shared language, dedicating time for modeling and feedback, and engaging in reflective techniques individually and in groups.

1. Facilitating the Development
of
Clinical Reasoning

2. I What is clinical reasoning?
II Why is it important?
III Reflective exercise
IV Strategies to develop reasoning

3. What is
clinical reasoning?

4. clinical reasoning?

5. diagnostic reasoning?
clinical reasoning?
professional reasoning?

6. the cognitive process that underlies diagnosis
and management of a patient’s presenting
problem
Linn, A., Khaw, C., Kildea, H., & Tonkin, A. (2012). Clinical reasoning - A guide to
improving teaching and practice. Australian Family Physician, 41(1-2), 18-20.

7. cognitive process
diagnosis
management
patients
problem

8. ability to integrate and apply different types of
knowledge, to weigh evidence, critically think
about arguments and to reflect upon the
process used to arrive at a diagnosis
Linn, A., Khaw, C., Kildea, H., & Tonkin, A. (2012). Clinical reasoning - A guide to
improving teaching and practice. Australian Family Physician, 41(1-2), 18-20.

9. cognitive process
diagnosis
management
patients
problem
integrate and apply
different types of knowledge
weigh evidence
think critically
reflect

10. cognitive process
diagnosis
management
p lex patients
c om rc es problem
sou
tiple integrate and apply
mul different types of knowledge
weigh evidence
think critically
reflect

12. ...practice skills and knowledge
...reasoning

13. technical rational
professional artistry
Fish, D. (1995). Quality Mentoring for Student Teachers: A
Principled Approach to Practice. London: David Fulton.

14. follows rules and laws
aims for efficient systems
knowledge is permanent
theory is applied to practice
technical expertise is all
quality = quantity
training

15. starts where rules fade
wants creativity
knowledge is dynamic
theory from practice
professional judgements
embraces uncertainty
education

16. technical rational
professional artistry
Fish, D. (1995). Quality Mentoring for Student Teachers: A
Principled Approach to Practice. London: David Fulton.

17. Expert
Novice

18. Expert
Novice
use past experience
perceive patterns
selective attention
perceive problems at a deep level
understand client perspective

19. clinical education
clinical education
clinical reasoning

21. strands of reflection
Fish, D. (1991). Developing a theoretical framework. In D. Fish, S. Twinn & B. Purr (Eds.), Promoting
Reflection: Improving the Supervision of Practice in Health Visiting and Initial Teacher Training (pp. 17-31).
London: West London Institute of Higher Education.

22. factual
retrospective
sub-stratum
connective

23. factual
reconstructing the experience, drawing
mainly on procedural knowledge of it

24. retrospective
developing a wholist theory about, and a
critique of, the entire experience, drawing
mainly on procedural knowledge of it

25. sub-stratum
uncovering and exploring critically the
personal theory which underlies the
experience, and considering how it relates to
and might be helped by formal theory

26. sub-stratum
uncovering and exploring critically the
personal theory which underlies the
experience, and considering how it relates to
and might be helped by formal theory

27. connective
considering how the experience might relate
to future experiences

28. factual
retrospective
sub-stratum
connective

29. Strategies to develop
s
clinical reasoning

30. Shared language

31. rack occupational interactive ethic
rative theoretical diagnostic three-
conditional collaborative procedu
scientific occupational ethical colla
thical narrative theoretical diagnos
scientific conditional collaborative
dural occupational interactive ethic
narrative theoretical diagnostic thr
ific conditional collaborative proce

32. Dedicated time

33. Model

34. Beware: tacit knowledge
Model

35. Vary expectations

36. 35

37. experience = learning
35

38. experience
+ reflection
learning
35

39. reflection
35

40. reflection
prospective / spective / retrospective
35

41. articulation
36

42. written verbal role play
articulation
36

43. articulation
problem representation
37

44. prioritise problem lists
38

45. provide feedback
39

46. read widely
40

48. Shared language
Dedicated time
Model
Techniques (individual, groups)
reflection
articulation
problem list prioritisation
provide feedback
read widely

49. factual
retrospective
sub-stratum
connective

50. factual
What did you do well?
retrospective
What could you do differently?
sub-stratum
connective

51. 2
actions as a result of this session