Clinical Reasoning Flashcards
Definition of Reasoning skills
“Reasoning skills encompass the ability to think critically, analyze information, and make sound
judgments based on evidence and logic.”
In physiotherapy:
• Critical thinking
• Decision making
What are the 3 différents clinical reasoning approach?
- Backward Reasoning
- Hypothetical-deductive process
- Iterative process
Explain Backward reasoning in clinical reasoning
- Backward reasoning
- Clinician starts w/ patient’s reported symptoms or clinical findings -> make an hypothesis - Hypothetical-deductive process
- Test the hypothesis ( H based on history taking, PE, Functional T, Imaging..) - Iterative process
- Revisits and adjusts Hypothesis
=> Reasoning backward : from observed clinical presentation to determine origine of the issue
What are the advantages of Backward reasoning?
- Systematic approach (all potential causes are considered)
- Adaptable (H can be updated)
- Efficient problem solving (prioritize testing most probable H)
- Evidence-based
A set of Hypothesis is generated
What is the pattern recognition approach in clinical reasoning?
A form of clinical reasoning that relies on identifying and matching a patient’s presentation to known patterns of symptoms or dysfunctions based on prior experience and knowledge.
What is a key characteristic of rapid diagnosis in pattern recognition?
The clinician identifies a familiar cluster of symptoms or signs that match a known condition.
True or False: The pattern recognition approach involves hypothesis generation and testing.
False
What does the pattern recognition approach heavily rely on?
The clinician’s expertise, prior clinical encounters, and pattern recall.
Fill in the blank: The pattern recognition approach is particularly useful in _______ conditions where established patterns are well-documented.
[common or straightforward]
What is a limitation of the pattern recognition approach?
Not ideal for atypical presentations.
What can happen if a clinician relies too much on past cases in pattern recognition?
It can lead to premature conclusions or diagnostic errors.
What is Bayesian reasoning in clinical practice?
A probability-based reasoning approach that integrates prior knowledge with new clinical findings.
What is the purpose of applying Bayesian reasoning?
To refine diagnoses by calculating post-test probabilities based on clinical signs.
What does dynamic updating in Bayesian reasoning involve?
Continually revising the likelihood of different diagnoses as more information is gathered.
List three advantages of Bayesian reasoning.
- Highly accurate
- Systematic and logical
- Evidence-based
What is a significant limitation of Bayesian reasoning?
It can be time-consuming.
True or False: Bayesian reasoning is simple for novices to implement.
False
What is required for effective use of Bayesian reasoning?
A solid understanding of statistics and clinical reasoning.
What does Bayesian reasoning encourage clinicians to use?
Research data to inform decisions.
Fill in the blank: Bayesian reasoning relies on the availability of accurate _______ and pre-test probabilities.
[likelihood ratios]
Clinical features of herniated disc LBP
- Radicular symptoms: sharp, shooting pain
in the leg following a dermatomal pattern.
• Weakness, numbness, or tingling in the leg.
• Worsened by sitting, bending, or coughing.
Screening tests for herniated disc LBP
- Straight Leg Raise (SLR): Positive if
radicular pain occurs between 30° -70° of hip flexion.
• Slump Test: Reproduces leg pain with
neural tension.
Imagine for herniated disc LBP
MRI confirms disc pathology if symptoms
persist.
