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International Handbook of Research in Medical Education pp 205–230Cite as

Clinical Reasoning

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Part of the book series: Springer International Handbooks of Education ((SIHE,volume 7))

Summary

The study of clinical reasoning 3 is important not only for defining the nature of medical competence and skill but also for providing insight into human cognition in general. The diagnostic problems that are the focus of clinical reasoning are instances of the complex, practical problems that characterize the real world, problems in which solutions depend heavily upon experience and knowledge (Elstein, Kagan, Shulman, Jason, & Loupe, 1972). Medical problems are examples of “everyday reasoning” tasks, which are characterized by implicit premises; contextual embedding; multiple possible answers; and ambiguity about the “best” solution (Galotti 1989). Clinical reasoning has often been conceptualized as a categorization task — once the clinician has categorized the patient’s problem into a class of diseases, the problem is treated as solved (Custers, Regehr & Norman, 1996). However, in contrast with the categorization tasks examined in laboratory studies in psychology, medical diagnosis categorizations are pervaded by ambiguity in the presence and identification of features and a large number of possible alternatives that often do not form clearly separable options (Brooks, LeBlanc & Norman, 2000).

Thus clinical reasoning research is both a special case of cognitive research on reasoning and problem solving generally and a valuable contributor to our broader understanding of human cognition. This review will seek to provide an overview of a large body of research in clinical reasoning in medicine and provide linkages with the research literature outside of medicine to substantiate and clarify specific points. By necessity it cannot include all relevant studies or theoretical treatments; rather a representative sampling has been sought.

Clinical reasoning, clinical problem solving, and diagnostic problem solving are treated as essentially synonymous terms in this chapter.

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  1. University of Michigan Medical School, USA

    Larry D. Gruppen & Alice Z. Frohna

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  1. McMaster University, Canada

    Geoff R. Norman

  2. University of Maastricht, The Netherlands

    Cees P. M. van der Vleuten  & Diana H. J. M. Dolmans  & 

  3. University of Sheffield, UK

    David I. Newble

  4. Dalhousie University, Canada

    Karen V. Mann

  5. University of Toronto, Canada

    Arthur Rothman

  6. CurryCorp, Canada

    Lynn Curry

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Gruppen, L.D., Frohna, A.Z. (2002). Clinical Reasoning. In: Norman, G.R., et al. International Handbook of Research in Medical Education. Springer International Handbooks of Education, vol 7. Springer, Dordrecht. https://doi.org/10.1007/978-94-010-0462-6_8

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