Principles and practice of case-based clinical reasoning education

Abstract

This chapter is devoted to clarifying terminology and concepts that have been regularly cited and used in the last decades around clinical reasoning. Thus, this chapter represents a conceptual overview. Success in clinical reasoning is essential to a physician’s performance. Clinical reasoning is both a process and an outcome (with the latter often being referred to as decision-making). While these decisions must be evidence based as much as possible, clearly decisions also involve patient perspectives, the relationship between the physician and the patient, and the system or environment where care is rendered. Definitions of clinical reasoning therefore must include these aspects. While definitions of clinical instruction of preclinical medical students. Many of these concepts reflect difficulties inherent to understanding how doctors think and how this type of thinking can be acquired by learners over time. Some provide hypotheses with more or less firm theoretical grounding, but a broad understanding of clinical reasoning requires an ongoing process of investigation. reasoning vary, they typically share the features that clinical reasoning entails: (i) the cognitive operations allowing physicians to observe, collect, and analyze information and (ii) the resulting decisions for actions that take into account a patient’s specific circumstances and preferences (Eva et al. 2007; Durning and Artino 2011). The variety of definitions of clinical reasoning and the heterogeneity in research is likely in part due to the number of fields that have informed our understanding of clinical reasoning. In this chapter, a number of concepts from a broad spectrum of fields is presented to help the reader understand clinical reasoning and to assist the