Evidence Based Clinical Reasoning In Medicine

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This book is open access under a CC BY 4.0 license. This volume describes and explains the educational method of Case-Based Clinical Reasoning (CBCR) used successfully in medical schools to prepare students to think like doctors before they enter the clinical arena and become engaged in patient care. Although this approach poses the paradoxical problem of a lack of clinical experience that is so essential for building proficiency in clinical reasoning, CBCR is built on the premise that solving clinical problems involves the ability to reason about disease processes. This requires knowledge of anatomy and the working and pathology of organ systems, as well as the ability to regard patient problems as patterns and compare them with instances of illness scripts of patients the clinician has seen in the past and stored in memory. CBCR stimulates the development of early, rudimentary illness scripts through elaboration and systematic discussion of the courses of action from the initial presentation of the patient to the final steps of clinical management. The book combines general backgrounds of clinical reasoning education and assessment with a detailed elaboration of the CBCR method for application in any medical curriculum, either as a mandatory or as an elective course. It consists of three parts: a general introduction to clinical reasoning education, application of the CBCR method, and cases that can used by educators to try out this method.

Using clinical examples and citing liberally from the peer-reviewed literature, this book shows how statistical priniciples can improve medical decisions.

Clinical reasoning is the foundation of professional clinical practice. Totally revised and updated, this book continues to provide the essential text on the theoretical basis of clinical reasoning in the health professions and examines strategies for assisting learners, scholars and clinicians develop their reasoning expertise. key chapters revised and updated nature of clinical reasoning sections have been expanded increase in emphasis on collaborative reasoning core model of clinical reasoning has been revised and updated

This book offers a philosophically-based, yet clinically-oriented perspective on current medical reasoning aiming at 1) identifying important forms of uncertainty permeating current clinical reasoning and practice 2) promoting the application of an abductive methodology in the health context in order to deal with those clinical uncertainties 3) bridging the gap between biomedical knowledge, clinical practice, and research and values in both clinical and philosophical literature. With a clear philosophical emphasis, the book investigates themes lying at the border between several disciplines, such as medicine, nursing, logic, epistemology, and philosophy of science; but also ethics, epidemiology, and statistics. At the same time, it critically discusses and compares several professional approaches to clinical practice such as the one of medical doctors, nurses and other clinical practitioners, showing the need for developing a unified framework of reasoning, which merges methods and resources from many different clinical but also non-clinical disciplines. In particular, this book shows how to leverage nursing knowledge and practice, which has been considerably neglected so far, to further shape the interdisciplinary nature of clinical reasoning. Furthermore, a thorough philosophical investigation on the values involved in health care is provided, based on both the clinical and philosophical literature. The book concludes by proposing an integrative approach to health and disease going beyond the so-called "classical biomedical model of care".

Employs a case-based approach to teach the basics of clinical reasoning, discusses steps in the clinical reasoning process, inductive and deductive strategies, data collection and its flaws, and assessing the reliability of clinical evidence.

Clinical reasoning lies at the core of health care practice and education. Clinical Reasoning in the Health Professions, therefore, occupies a central place in the education of health professionals, the enhancement of professional decision making of individuals and groups of practitioners with their clients, and research into optimal practice reasoning. All chapters updated and 20 new chapters added Concrete examples, cases and vignettes were added to bring discussions to life for the reader Reflection points strategically placed to assist readers to extend their insights and build learning from their own practical experiences and theoretical knowledge Devices of particular value to reflective practitioners and educators All chapters updated and 20 new chapters added Concrete examples, cases and vignettes were added to bring discussions to life for the reader Reflection points strategically placed to assist readers to extend their insights and build learning from their own practical experiences and theoretical knowledge Devices of particular value to reflective practitioners and educators.

The presentation is consistently excellent. One, the writing is lucid and organized in a way that should be very natural for the clinical reader. Two, the text requires no background in mathematics and uses a minimum of symbols. And, three, the methodological concepts and clinical issues are well integrated through a number of carefully prepared and comprehensive examples. Greg Samsa, Associate Director, Duke Center for Clinical Health Policy Research If a patient is older or younger than, sicker or healthier than, taller or shorter than or simply different from the subjects of a study, do the results pertain? Clinical Epidemiology & Evidence-based Medicine is a resource for all health-care workers involved in applying evidence to the care of their patients. Using clinical examples and citing liberally from the peer-reviewed literature, the book shows how statistical principles can improve medical decisions. Plus, as Katz shows how probability, risk and alternatives are fundamental considerations in all clinical decisions, he demonstrates the intuitive basis for using clinical epidemiolgy as a science underlying medical decisions. After reading this text, the practitioner should be better able to access, interpret, and apply evidence to patient care as well as better understand and control the process of medical decision making.

Being a good clinician is not only about knowledge — how doctors and other healthcare professionals think, reason, and make decisions is arguably their most critical skill. The second edition of the ABC of Clinical Reasoning breaks down clinical reasoning into its core components and explores each of these in more detail, including the applications for clinical practice, teaching, and learning. Informed by the latest evidence from cognitive psychology, education, and studies of expertise, this edition has been extensively re-written and updated, and covers: Key components of clinical reasoning: evidence-based history and examination, choosing and interpreting diagnostic tests, problem identification and management, and shared decision-making Key concepts in clinical reasoning, such dual process theories, and script theory Situativity and human factors Metacognition and cognitive strategies Teaching clinical reasoning From a team of expert authors, the ABC of Clinical Reasoning is essential reading for all students, clinical teachers, curriculum planners and clinicians involved in diagnosis.

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.