Judgment and Reasoning in Professional Contexts

Chapter

Abstract

Clinical practice is a complex set of knowledge–judgment–reasoning–practice interactions embedded in a framework of professional duty of care and enacted in multiple changing contexts. This chapter explores the topics of judgment and decision making, presenting these as complex practices within professional practice. As a complex field of practice, catheter-based cardiovascular intervention requires a rich and contemporary understanding of clinical reasoning practice, encompassing professionalism, accountability, and expectations. Professional practice is about knowingly and deliberately practicing, and making judgments and decisions based on an in-depth knowledge of practice and how it is framed by practitioners and practice communities. The complexity and quality of clinical reasoning lies in the very nature of the reasoning challenge faced by novice and expert alike, which is to process multiple variables in a range of task spaces, contemplate the various priorities of competing healthcare needs, negotiate the interests of different participants in the decision-making process, inform all decisions and actions with advanced practice knowledge, and make all decisions and actions in the context of professional ethics and community expectations. Quality in clinical reasoning and judgment is a referential, critically applied commitment and pursuit, not a straightforward point of arrival and application.

References

  1. 1.
    Higgs J, McAllister L, Whiteford G. The practice and praxis of professional decision making. In: Green B, editor. Understanding and researching professional practice. Rotterdam: Sense; 2009. p. 101–20.Google Scholar
  2. 2.
    Higgs J, Titchen A. Preface. In: Higgs J, Titchen A, editors. Professional practice in health, education and the creative arts. Oxford: Blackwell Science; 2001. p. x–xii.CrossRefGoogle Scholar
  3. 3.
    Higgs J. Practice-based education: the practice–education–context–quality nexus. In: Higgs J, Barnett R, Billett S, Hutchings M, Trede F, editors. Practice-based education: perspectives and strategies. Rotterdam: Sense; 2012. p. 3–12.CrossRefGoogle Scholar
  4. 4.
    Higgs J. Deliberately owning my practice model: realising my professional practice. In: Trede F, McEwen C, editors. Educating the deliberate professional: preparing practitioners for emergent futures. Dordrecht: Springer; 2016. p. 189–203.Google Scholar
  5. 5.
    Habermas J. Knowledge and human interest (trans. Shapiro JJ 1972). London: Heinemann; 1968.Google Scholar
  6. 6.
    Habermas J. Truth and justification (ed. and trans. Fultner B). Cambridge: MIT Press; 2003.Google Scholar
  7. 7.
    Higgs J, Trede F, Rothwell R. Qualitative research interests and paradigms. In: Higgs J, Titchen A, Horsfall D, Armstrong H, editors. Being critical and creative in qualitative research. Sydney: Hampden Press; 2007. p. 32–42.Google Scholar
  8. 8.
    Higgs J. The complexity of clinical reasoning: exploring the dimensions of clinical reasoning expertise as a situated, lived phenomenon. In: Seminar presentation at the Faculty of Health Sciences. Sydney: The University of Sydney; 2006.Google Scholar
  9. 9.
    Paterson M, Higgs J. Professional practice judgement artistry. In: Higgs J, Jones M, Loftus S, Christensen N, editors. Clinical reasoning in the health professions. 3rd ed. Edinburgh: Elsevier; 2008. p. 181–9.Google Scholar
  10. 10.
    The Macquarie concise dictionary. 3rd ed. Sydney: Macquarie Library; 1998.Google Scholar
  11. 11.
    Mirriam-Webster dictionary. https://www.merriam-webster.com/dictionary/evidence (28 Feb 2017).
  12. 12.
    Turpin M, Higgs J. Clinical reasoning and evidence-based practice. In: Hoffman T, Bennett S, Bennett J, Del Mar C, editors. Evidence-based practice across the health professions. 2nd ed. Melbourne: Elsevier; 2013. p. 353–69.Google Scholar
  13. 13.
    Jones M, Grimmer K, Edwards I, Higgs J, Trede F. Challenges in applying best evidence to physiotherapy. Internet Journal of Allied Health Science and Practice. 2006;4(3):1–8.Google Scholar
  14. 14.
    Jones MA, Grimmer K, Edwards I, Higgs J, Trede F. Challenges in applying best evidence to physiotherapy practice: part 2—reasoning and practice challenges. Internet Journal of Allied Health Science and Practice. 2006;4(4):1–9.Google Scholar
  15. 15.
    Sackett D, Straus S, Richardson W, Rosenberg W, Haynes R. Evidence-based medicine: how to practice and teach EBM. 2nd ed. Edinburgh: Elsevier Churchill Livingstone; 2000.Google Scholar
  16. 16.
    Naylor C. Grey zones of clinical practice: some limits to evidence-based medicine. Lancet. 1995;345:840–1.CrossRefGoogle Scholar
  17. 17.
    Rycroft-Malone J, Seers K, Titchen A, Harvey G, Kitson A, McCormack B. What counts as evidence in evidence-based practice? J Adv Nurs. 2004;47(1):81–90.CrossRefGoogle Scholar
  18. 18.
    Small N. Knowledge, not evidence, should determine primary care practice. Clin Governance. 2003;8:191–9.CrossRefGoogle Scholar
  19. 19.
    Higgs J, Jones M. Clinical decision making and multiple problem spaces. In: Higgs J, Jones M, Loftus S, Christensen N, editors. Clinical reasoning in the health professions. 3rd ed. Edinburgh: Elsevier; 2008. p. 3–17.Google Scholar
  20. 20.
    Higgs J, Jones M. Multiple spaces of choice, engagement and influence in clinical decision making. In: Higgs J, Jensen G, Loftus S, Christensen N, editors. Clinical reasoning in the health professions. 4th ed. Edinburgh: Elsevier; 2011.Google Scholar
  21. 21.
    Boshuizen HPA, Schmidt HG. On the role of biomedical knowledge in clinical reasoning by experts, intermediates and novices. Cogn Sci. 1992;16:153–84.CrossRefGoogle Scholar
  22. 22.
    Boshuizen H, Schmidt H. The development of clinical reasoning expertise. In: Higgs J, Jones M, Loftus S, Christensen N, editors. Clinical reasoning in the health professions. 3rd ed. Edinburgh: Elsevier; 2008. p. 113–21.Google Scholar
  23. 23.
    Boshuizen HPA, Schmidt HG. The development of clinical reasoning expertise. In: Higgs J, Jones M, Loftus S, Christensen N, editors. Clinical reasoning in the health professions. 4th ed. Edinburgh: Elsevier; 2011.Google Scholar
  24. 24.
    Coulter A. Shared decision-making: the debate continues. Health Expect. 2005;8:95–6.CrossRefGoogle Scholar
  25. 25.
    Bowles W, Patton N. Expectations and responsibilities. In: Higgs J, Croker A, Tasker D, Hummell J, Patton N, editors. Health practice relationships. Rotterdam: Sense; 2014. p. 101–8.Google Scholar
  26. 26.
    Trede F, McEwen C. Scoping the deliberate professional. In: Trede F, McEwen C, editors. Educating the deliberate professional: preparing practitioners for emergent futures. Dordrecht: Springer; 2016. p. 3–14.Google Scholar
  27. 27.
    Hogarth RM. Deciding analytically or trusting your intuition? The advantages and disavantages of analytic and intuitive thought. In: Betsch T, Haberstroh S, editors. The routines of decision making. Mahwah: Lawrence Erlbaum Associates; 2005. p. 67–82.Google Scholar
  28. 28.
    Schwartz A, Elstein AS. Clinical reasoning in medicine. In: Higgs J, Jones M, Loftus S, Christensen N, editors. Clinical reasoning in the health professions. 3rd ed. Edinburgh: Elsevier; 2008. p. 223–34.Google Scholar
  29. 29.
    Croker A, Higgs J. The RESPECT model of collaboration. In: Croker A, Higgs J, Trede F, editors. Collaborating in healthcare: reinterpreting therapeutic relationships. Rotterdam: Sense; 2016. p. 43–54.CrossRefGoogle Scholar
  30. 30.
    Nisbet G. Scrutinising our assumptions of the other professions: acknowledging and supporting the diversity within. In: Croker A, Higgs J, Trede F, editors. Collaborating in healthcare: reinterpreting therapeutic relationships. Rotterdam: Sense; 2016. p. 253–60.CrossRefGoogle Scholar
  31. 31.
    Ajjawi R, Higgs J. Learning to communicate in clinical reasoning. In: Higgs J, Jones M, Loftus S, Christensen N, editors. Clinical reasoning in the health professions. 3rd ed. Edinburgh: Elsevier; 2008. p. 331–8.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Charles Sturt UniversitySydneyAustralia

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