<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2014-9832</journal-id>
<journal-title><![CDATA[FEM: Revista de la Fundación Educación Médica]]></journal-title>
<abbrev-journal-title><![CDATA[FEM (Ed. impresa)]]></abbrev-journal-title>
<issn>2014-9832</issn>
<publisher>
<publisher-name><![CDATA[Fundación Educación Médica y Viguera Editores, S.L.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2014-98322017000400002</article-id>
<article-id pub-id-type="doi">10.33588/fem.204.903</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Razonamiento clínico]]></article-title>
<article-title xml:lang="en"><![CDATA[Clinical reasoning]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez de Castro]]></surname>
<given-names><![CDATA[Felipe]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Carrillo-Díaz]]></surname>
<given-names><![CDATA[Teresa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Freixinet-Gilart]]></surname>
<given-names><![CDATA[Jorge]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Julià-Serdà]]></surname>
<given-names><![CDATA[Gabriel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Las Palmas de Gran Canaria Hospital Universitario de Gran Canaria Dr. Negrín Departamento de Ciencias Médicas y Quirúrgicas]]></institution>
<addr-line><![CDATA[Las Palmas de Gran Canaria ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2017</year>
</pub-date>
<volume>20</volume>
<numero>4</numero>
<fpage>149</fpage>
<lpage>160</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S2014-98322017000400002&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S2014-98322017000400002&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S2014-98322017000400002&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Todas las actuaciones médicas tienen una curva de aprendizaje, pero el razonamiento clínico se mantiene como un elemento clave en cualquiera de ellas. Los médicos experimentados manejan una gran cantidad de información en cualquier proceso clínico. Para conseguir la máxima eficiencia en la utilización de esta información, los clínicos emplean una serie de estrategias que les permiten combinar datos y sintetizarlos en un número reducido de hipótesis diagnósticas, evaluar los riesgos y los beneficios de realizar nuevos procedimientos diagnósticos y aplicar determinados tratamientos, y formular planes en el manejo del paciente. Uno de los objetivos principales de cualquier docente médico es promover el desarrollo de una forma de razonar experta en sus estudiantes. Sin embargo, enseñar estas habilidades cognitivas no es tarea sencilla porque no existe una teoría completa y ampliamente aceptada acerca de los procesos de razonamiento clínico, e incluso los médicos más experimentados a menudo no son conscientes de los métodos de razonamiento que utilizan para alcanzar un diagnóstico. Desde hace más de cuarenta años se ha investigado en este campo. En este artículo se revisan las bases científicas y las teorías propuestas a lo largo de este período acerca del modo de razonar de los clínicos. También se analiza la evolución de las estructuras del conocimiento y se examinan algunos errores frecuentes en razonamiento diagnóstico. Por último, se proponen algunas recomendaciones prácticas específicas para ayudar a los principiantes a fortalecer sus habilidades de razonamiento diagnóstico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Summary 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.]]></p></abstract>
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<kwd lng="es"><![CDATA[Razonamiento clínico]]></kwd>
<kwd lng="es"><![CDATA[Razonamiento diagnóstico]]></kwd>
<kwd lng="en"><![CDATA[Clinical reasoning]]></kwd>
<kwd lng="en"><![CDATA[Diagnostic reasoning]]></kwd>
</kwd-group>
</article-meta>
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