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FEM: Revista de la Fundación Educación Médica

On-line version ISSN 2014-9840Print version ISSN 2014-9832


RODRIGUEZ DE CASTRO, Felipe; CARRILLO-DIAZ, Teresa; FREIXINET-GILART, Jorge  and  JULIA-SERDA, Gabriel. Clinical reasoning. FEM (Ed. impresa) [online]. 2017, vol.20, n.4, pp.149-160.  Epub Aug 16, 2021. ISSN 2014-9840.

There is a learning curve in almost everything doctors do, but judgment remains a key determinant of the value of any clinical intervention. Expert physicians manage huge amounts of information to ensure the quality of patient care by using a set of efficient reasoning strategies. These strategies allow them to combine and synthesize data into a few diagnostic hypotheses, assess benefits and risks of additional diagnostic procedures and treatments, and articulate plans for patient management. A major goal of the medical educators is to foster the development of expert clinical reasoning in apprentices. However, teaching these cognitive skills is a difficult task because there is no generally accepted inclusive theory of the clinical reasoning process and even the most seasoned clinicians are often unaware of the reasoning methods that lead them to achieve accurate diagnoses. Research in this field has been carried out for over 40 years. In this paper we review the scientific background and theories proposed throughout this time about how clinicians reason. We also analyze the evolution of knowledge structures and examine some common errors in diagnostic reasoning. Finally, we provide several practical and specific recommendations to help learners strengthen their diagnostic reasoning skills.

Keywords : Clinical reasoning; Diagnostic reasoning.

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