Clinical Reasoning: Knowledge, Uncertainty, and Values in Health Care

2021 ◽  
Author(s):  
Daniele Chiffi
Keyword(s):  
Health Care ◽  
Clinical Reasoning ◽  
Knowledge Uncertainty

scholarly journals Electronic Medical Education Effect on Learner Application of Health Care Knowledge in Iran

2019 ◽  
pp. 1-5
Author(s):  
Shima Tabatabai
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Clinical Reasoning ◽  
Controlled Trial ◽  
Basic Knowledge ◽  
Medical Education Program ◽  
Significant Difference ◽  
E Learning ◽  
Level Of Knowledge ◽  
Scientific Meetings

Background: Like most of countries, medical education in Iran consists of undergraduate, postgraduate, and continuing medical education (CME). The use of Internet technologies, have been integrated into all three level of medical education. The effect of Electronic medical education on application of health care knowledge in compare with traditional medical education could show the effectiveness of program. Aims: The aim of this study is to examine the effect of E-Learning on application level of knowledge &clinical reasoning issues as compared to lecture-based learning in a medical education program. Study Design and Methodology: This randomized controlled trial was conducted in scientific meetings for 68 Physicians. Knowledge assessment tests were performed before and immediately after E-Learning and lecture-based educational session. Results: A significant improvement at the application level of knowledge & clinical reasoning was found in both groups (P < 0.01). There was no significant difference between the E-Learning & traditional educational approaches. Course completers had significant improvements in application level of health care knowledge. Conclusion: The effect of E-Learning in medical education and on learner basic knowledge, application of health care knowledge in response to clinical vignettes is comparable to a lecture-based approach. Therefore, E-Learning can be effective in all levels of Medical Education, and it will enable Physicians to have a self-directed learning with choosing the place and time of their lifelong learning process.

Improving diagnosis by improving education: a policy brief on education in healthcare professions

Diagnosis ◽  
2018 ◽  
Vol 5 (3) ◽  
pp. 107-118 ◽  
Author(s):  
Mark L. Graber ◽  
Joseph Rencic ◽  
Diana Rusz ◽  
Frank Papa ◽  
Pat Croskerry ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Reasoning ◽  
Health Care Professionals ◽  
Interprofessional Education ◽  
Safety Concern ◽  
Diagnostic Error ◽  
Education And Training ◽  
Diagnostic Process ◽  
Specific Content ◽  
And Training

Abstract Diagnostic error is increasingly recognized as a major patient safety concern. Efforts to improve diagnosis have largely focused on safety and quality improvement initiatives that patients, providers, and health care organizations can take to improve the diagnostic process and its outcomes. This educational policy brief presents an alternative strategy for improving diagnosis, centered on future healthcare providers, to improve the education and training of clinicians in every health care profession. The hypothesis is that we can improve diagnosis by improving education. A literature search was first conducted to understand the relationship of education and training to diagnosis and diagnostic error in different health care professions. Based on the findings from this search we present the justification for focusing on education and training, recommendations for specific content that should be incorporated to improve diagnosis, and recommendations on educational approaches that should be used. Using an iterative, consensus-based process, we then developed a driver diagram that categorizes the key content into five areas. Learners should: 1) Acquire and effectively use a relevant knowledge base, 2) Optimize clinical reasoning to reduce cognitive error, 3) Understand system-related aspects of care, 4) Effectively engage patients and the diagnostic team, and 5) Acquire appropriate perspectives and attitudes about diagnosis. These domains echo recommendations in the National Academy of Medicine’s report Improving Diagnosis in Health Care. The National Academy report suggests that true interprofessional education and training, incorporating recent advances in understanding diagnostic error, and improving clinical reasoning and other aspects of education, can ultimately improve diagnosis by improving the knowledge, skills, and attitudes of all health care professionals.

Syncing Our Global Thinking: A Framework for Contextualized Clinical Reasoning

2021 ◽  
pp. 1-10
Author(s):  
Thiani Pillay ◽  
Mershen Pillay
Keyword(s):  
Health Care ◽  
Clinical Reasoning ◽  
Health Care Services ◽  
Best Practice ◽  
Care Provision ◽  
Care Services ◽  
Health Care Practitioners ◽  
The Impact ◽  
Clinical Reasoning Skills ◽  
Effective Health Care

Purpose Globally, health care practitioners (HCPs) practice in a variety of settings. To account for the diversity of these contexts, HCPs should utilize dynamic clinical reasoning skills to provide contextually responsive services that account for the complexities of patients, clinicians, and their surroundings. However, traditional models of clinical reasoning approach this skill in a reductionistic and segmented manner that ignores the impact of these diverse factors in health care provision. This makes it very difficult to reconcile these models with the realities of practice. Method By repositioning clinical reasoning as a unique and dynamic skill and identifying the shortcomings of traditional clinical reasoning models, we suggest a novel theoretical framework: contextualized clinical reasoning , which centralizes factors related to context and individual within its approach. Conclusions In order to practice clinical reasoning in an authentic manner that recognizes the impact of contextual and personal realities, we put forward the contextualized clinical reasoning framework. This framework gives HCPs the tools needed to change the rhetoric on best practice and provide effective health care services that account for complexity and diversity of health care contexts globally.

Virtual Patient Simulation Training in Graduate Dysphagia Management Education—A Research-Led Enhancement Targeting Development of Clinical Interviewing and Clinical Reasoning Skills

2016 ◽  
Vol 1 (13) ◽  
pp. 130-139
Author(s):  
Isaac Sia ◽  
Shivashankar Halan ◽  
Benjamin Lok ◽  
Michael A. Crary
Keyword(s):  
Health Care ◽  
Nursing Education ◽  
Clinical Reasoning ◽  
Clinical Education ◽  
Simulation Training ◽  
Virtual Patient ◽  
Conversational Agents ◽  
Clinical Interviewing ◽  
Reasoning Skills ◽  
Clinical Reasoning Skills

Access to patients for clinical education is a challenge for educators and students across all health care professions. Led by colleagues in medical and nursing education, health care educators have increasingly embraced new teaching technologies such as virtual patient (VP) simulation training to support certain aspects of clinical education. This paper presents an account of the systematic, multi-year, research-led incorporation of computer generated virtual humans (i.e., embodied conversational agents) in a dysphagia management course targeting development of clinical interviewing and clinical reasoning skills in graduate speech-language pathology students.

scholarly journals Scaffolding Clinical Reasoning of Health Care Students: A Qualitative Exploration of Clinicians’ Perceptions on an Interprofessional Obstetric Ward

2020 ◽  
Vol 7 ◽  
pp. 238212052090791 ◽  
Author(s):  
Cora LF Visser ◽  
Anouk Wouters ◽  
Gerda Croiset ◽  
Rashmi A Kusurkar
Keyword(s):  
Health Care ◽  
Clinical Reasoning ◽  
Interprofessional Education ◽  
Just In Time ◽  
Peer Assisted Learning ◽  
Pedagogical Approach ◽  
Health Care Students ◽  
Care Plans ◽  
Conventional Content Analysis ◽  
Qualitative Exploration

Purpose: Interprofessional education (IPE) on a ward supports students to generate interprofessional patient care plans as a means to learn about the roles, responsibilities, and clinical reasoning of other professions. We investigated how clinicians guide the clinical reasoning of students from their own and other professions and whether clinicians from nursing, midwifery, and medicine could scaffold students from all professions, that is, by providing just-in-time and tailored support. Methods: Nine supervising clinicians from medicine, nursing, and midwifery were interviewed and a repeat interview held 3 to 15 weeks later; one nurse supervisor was interviewed only once. Using conventional content analysis, themes were identified inductively. Next, we applied an existing scaffolding framework to conceptualise how clinicians supported the clinical reasoning in an IPE setting. Results: Themes were clinicians’ interventions and intentions, results of interventions and of IPE, characteristics of students and clinicians, interactions between clinicians and students, and logistics. Clinicians applied various interventions and expressed several intentions to guide the learning of students from all professions. Clinicians stimulated students’ clinical reasoning by structuring meetings, asking students to explain their thoughts to each other and through giving group assignments. Thus, clinicians used peer-assisted learning for the students. By collaborating with other supervising clinicians regarding the form and amount of guidance to give to the students, clinicians applied peer-assisted learning for themselves as well. Conclusion: Clinicians can learn to scaffold the clinical reasoning of students from different professions, when they are provided with training, good examples, and structures. An existing scaffolding framework can serve as an overview of aims and interventions to provide just-in-time guidance to students from all professions. The scaffolding framework is useful for training clinicians and for depicting the pedagogical approach for IPE wards.

scholarly journals A Framework for Neurodevelopmental Disorders: Operationalization of a Pathogenetic Triad for Clinical and Research Use

2019 ◽  
Author(s):  
Darko Sarovic
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Clinical Reasoning ◽  
Environmental Risk ◽  
Neurodevelopmental Disorders ◽  
Health Care Services ◽  
Research Use ◽  
Contributing Factors ◽  
Care Services ◽  
Exogenous Factors

The relevance of neurodevelopmental disorders, even outside of health care services, has become increasingly acknowledged. Endogenous, as well as exogenous, factors have been shown to influence their development, and the effects and interactions of those factors have been extensively discussed. Despite this, an operationalized and clinically relevant framework that aids clinical reasoning and diagnostics is lacking. This paper presents a framework for conceptualizing the pathogenesis of neurodevelopmental disorders from the interaction of a triad of contributing factors: genetic susceptibility, cognitive compensation, and environmental risk factors. The triad is operationalized to create a clinically relevant framework and approaches for quantification of each operationalized variable are presented. This allows clinicians to implement the framework in a practical setting, potentially improving diagnostics, and provides researchers with an explanatory framework for their findings. Methods for testing and validation of the triad are outlined.

scholarly journals Telehealth as a medical education tool during the COVID-19 pandemic: experience report

2021 ◽  
Vol 45 (3) ◽  
Author(s):  
Matheus Augusto Obici Massucato ◽  
Ana Luísa Green Ribeiro ◽  
Juliana Dias Reis Pessalacia ◽  
Vinicius de Jesus Rodrigues Neves ◽  
Vânia Paula Stolte-Rodrigues
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Clinical Reasoning ◽  
Medical Patient ◽  
Experience Report ◽  
Evidence Based ◽  
Face To Face ◽  
Education Experience ◽  
Education Tool ◽  
Teaching Learning

Abstract: Introduction: The Covid-19 pandemic interrupted and challenged the traditional structure of medical education, based on face-to-face teaching, and, as a measure of support for the efforts of government agencies to reduce the risk of spreading the disease, distance became necessary. medical/patient care and the increase in the supply of telehealth services by health systems. In Brazil, the telehealth model seeks to improve the quality of care in primary health care (PHC), integrating education and service through tele-education and tele-assistance activities, such as teleconsulting, the Second Formative Opinion (SOF), tele-education and telediagnosis. Thus, this article reports the experience of medical students in telehealth actions during the Covid-19 pandemic in Brazil, seeking to clarify the contributions and limitations of this experience in the teaching-learning process in the context of medical education. Experience report: Participation in the project allowed the experience of various telehealth activities under the supervision and guidance of professors in the health area, in addition to the production of informative and educational materials. The proposed activities allowed for the improvement of clinical reasoning through evidence-based medicine (EBM), especially in helping teleconsultations and frequently asked questions. Discussion: The use of technologies became indispensable during the pandemic, and, within this scenario, a telehealth project proved to be an important and effective strategy for continuing education among professionals and health education for the community, avoiding crowding and preventing the spread of the virus. In addition, remote actions, such as teleconsultations, resolution of frequently asked questions and tele-education, proved to be an important strategy for accessing health care not only in times of pandemic. Conclusion: Our experience made it possible to foster critical thinking and disseminate content in a safe, technical and evidence-based way. The exercise of clinical reasoning led us to an experience of great value and to believe that the inclusion of the practice of telehealth can bring important gains to the curriculum of Medicine courses.

Sign in / Sign up

Export Citation Format

Share Document