L4 - Advanced CLinical Reasoning

Question 1

what does clinical reasoning include

Answer 1

• the patients’ perspectives on their problem
• the creation and maintenance of a therapeutic relationship
• a variety of potential solution (Higgs et al 2009)

Question 1

what is clinical reasoning

Answer 1

the process of determining a prioritised list of patients main problems and potential treatment options.

Question 2

Why does Clinical Reasoning Matter?

Answer 2

• It’s how we make logical decisions. and our problem lists and treatment plans
• It’s using our analytical skills, problem solving and metacognition
• It’s how we ensure safe practice
• It’s how we ensure practice is evidence based and up to date
• It’s how we demonstrate how we made reasoned decisions
• It can evidence that we may have had to follow legislation and policy or clinical protocols

Question 3

what are the 10 types of clinical reasoning

Answer 3

• procedural
• hypo-deductive reasoning
• pattern recognition
• conditional
• narrative
• clinical clues and flags
• evidence based approaches
• interactive reasoning
• scientific reasoning
• legal framework

Question 4

desrcibe procedural clinical reasoning

Answer 4

the procedures the professional may use and the pathways people may follow

Question 5

describe hypo-deductive reasoning

Answer 5

Looking for clues/ signs and building a clinical picture/ history

Question 6

describe pattern recognition clinical reasoning

Answer 6

Classic signs and have seen the pattern before. However, caution is also required.

Question 7

describe clinical cues and flags clinical reasoning

Answer 7

• A cue is something that is said or done that acts as a signals to take action.
• In physiotherapy, we use an established flag system:
  
  • Red flags are indicators of serious pathology.
  • Yellow flags are psychological and social issues.
  • blue flags are related to work.

Question 8

describe evidence based approaches clinical reasoning

Answer 8

• utilising the evidence base
• national guidelines
• best practice guidelines
• research
• NICE guidelines

Question 9

what is advanced clinical reasoning

Answer 9

• Utilising a range of reasoning models to fit the clinical scenario
• Integration of evidence base
• Additional of experience gained through university teaching, simulated practice and clinical observation
• Efficiency of subjective questioning and objective assessment prioritised

Question 10

what are the potential disadvantages of using more experience-based clinical reasoning models

Answer 10

• potential for less person centred approach, i.e. following an approach that has worked for a patient with a similar condition or problem may not lend itself to being person centred
• potential for complacency and missing key information
• no two patients are the same, in terms of pathology, anatomy, physiology
• without reflective practice, and outcome measures, how would we know previous treatment has been effective?