Clinical Reasoning Flashcards
What does clinical reasoning of a healthcare professional involve?
Cognitive & physical processes that emerge when trying to solve problems and make decisions in order to develop a therapeutic management plan to improve patients well being
Poor reasoning may lead to…
Diagnostic error or failure of treatment
Negative impact on patient
Poor relationship between you and patient
Disputes
Metacognition
Thinking about thinking, being aware of decision making process & reflecting on situation
Dual processing theory- 2 types of thinking
System 1–> fast
System 2–> slow
Fast dual processing theory
-relies on what
-characteristics of it
-conscious/unconscious cognition?
-automatic or controlled?
-disadvantage
Relies heavily on pattern recognition
Intuitive, drawing on past experiences & emotion
Feels right
Unconscious cognition, automatic
More prone to error
Slow dual processing theory
-characteristics of it
-conscious/unconscious cognition?
-automatic or controlled?
-disadvantage
Analytical, problem oriented approach
Unfamiliar situations
Critical evaluation of evidence and facts
Conscious cognition, deliberate effort and control
Overthinking
What is cognitive load theory
Amount of information our working memory can process
3 types of cognitive bias
Availability
Visceral
Zebra retreat
Availability
Considering diagnoses that more readily come to mind, if a disease has not been seen for a long time it becomes less available
Visceral
Thinking swayed by first impression upon meeting a patient or client, positive or negative feelings may affect decision making
Zebra retreat
Hesitation to consider a rare disease diagnosis even though it may be most likely
Semantic qualifiers & examples
Technical descriptor terms that narrow or specify part of a case presentation
E.g acute/chronic, acquired/congenital, erythematous, purulent etc
Illness scripts
The story or mental representation of how a particular disease typically presents
Encapsulations
Compilations of a group of clinical signs eg otitis external, renal failure, CHF
Schema
Large, well organised, defined chunks of information/knowledge
What is context specificity
When a clinician arrives at different outcomes for different patients who essentially have the same clinical presentation/diagnosis
In veterinary Situativity theory states that the clinical outcome of a patient depends on what 4 factors
Give examples of each
Physician factors- knwoeldge, clinical skills, communication, well-being, experience, motivation
Encounter factors- location, support systems, appointment length, time of day, staff
Patient factors- acuteness of illness, complexity of illness, communication, education
Owner factors- human-animal bond, finances, physical ability, education, experience, public health concerns, lack of history
What is contextualised care
A way of delivering veterinary care that acknowledges that there are different ways to approaching the diagnostics & treatment of an animal, depending on the circumstances of the individual & their caregivers, and the context in which the care is delivered. We must adapt to individual case circumstances to provide the most appropriate individualised care for that patient.
What is spectrum of care
A continuum of acceptable care options which would satisfy all stakeholders
What is pragmatic decision making
A way of solving problems in a sensible and practical way and not being bound by certain ideas only or overacting on a single defined cause
SNAPPS pneumonic used to present cases step by step
Summarise
Narrow
Analyse
Probe
Plan
Strategic planning
