Judgment and Reasoning in Professional Contexts

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.