Clinical Reasoning Flashcards
What is clinical reasoning?
A process by which clinicians collect, analyse and interpret information to make an accurate diagnosis and develop a plan of action
What are the key elements of clinical reasoning?
1 - Clinical skills
2 - Using & interpreting diagnostic tests including history & examination
3 - Cognitive biases and human factors
4 - Critical thinking
5 - Patient centred evidence based medicine
6 - Shared decision making
What is diagnostic reasoning?
1 - Obtain information from a patient (history & examination)
2 - Compare that information to their understanding of different diseases
3 - Develop a working diagnosis which can drive investigation and treatment plans
Where can clinical reasoning go wrong?
- Knowledge
- Failing to generate enough diagnoses
- Failing to appreciate the patient’s agenda
- Closing down differentials too soon
- Generating inappropriate working diagnosis
- Cognitive bias
What are 2 examples of differential diagnosis checklists?
I VINDICATE AID
MEDIC HAT PIN
What are differential diagnosis checklists otherwise known as?
Surgical sieve’s
What is the purpose of a surgical sieve?
- A surgical sieve is useful in helpful you widen your differential diagnosis list
- Useful in complicated conditions where the diagnosis is not clear
Which model do we use to make a diagnosis?
Hypothetico-deductive model
What is the dual process theory of making a diagnosis?
System 1 Thinking:
- Intuition easy ‘pattern recognition’
- Thinking fast
System 2 Thinking:
- Extensive information gathering and hypothesis generation
- Thinking slow, consumes more mental effort
What is cognitive load theory?
- Short-term working memory can only process so many pieces of information simultaneously
- The memory ‘chunks’ into larger units for easier storage and access
- Chunking uses long-term working memory which is believed to have endless capacity.
