Higgs and Jones(2000) outline the following approaches to Clinical Reasoning.
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Hypothetico-deductive reasoning – The clinician formulates a hypothesis after observing their patient/client and combines this with their existing knowledge. Than they aim to confirm diagnosis with further tests.
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Pattern Recognition - The clinician relies on knowledge and experience of common presentations which they recognise in a new patient/client.
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Knowledge reasoning integration - The integration of a clinicians knowledge/cognitive skills with reasoning
- Interpretive reasoning styles:
- Diagnostic reasoning - Aims to reveal the patients/clients impairments
- Interactive reasoning – Developed from patients/clients interactions
- Narrative reasoning – Reasoning based on stories which give us an understanding of the patient/clients motivations and actions.
- Collaborative reasoning – Shared decision making
- Predictive or conditional reasoning – Predicting what will occur based on information collected
- Ethical reasoning – Reasoning based on our ethical thinking
- Teaching as reasoning - Conscious use of advice, guidance and instruction to change patients' understandings, feelings and behaviours
It is generally recognised that most professionals will use a variety of approaches based on their individual circumstances.
Reflection Activity
How do you reason?
Do you have a particular style/favored method?
Do you change according to the circumstance?
Consider for each approach, if your student used that approach in your setting, would it pose any particular challenge? If a student demonstrated this approach, would you attempt to modify their approach? If so, why and how would you do it?
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