Medical education: Theories on clinical reasoning

Abstract

Formulating an appropriate working diagnosis and plausible differential diagnoses is the hallmark of good clinical practice. Clini­cal reasoning is defined as the cognitive process that leads to a diagnosis and the formulation of a diagnostic plan. The process of clinical reasoning is discussed in terms of analytic, nonanalytic, and dual-process theories. Nonanalytic processes are experiential, intuitive, and are often triggered automatically. Analytic processes are hypothetico-deductive, and they operate during unfamiliar or complex scenarios. Both process categories are at play in the dual-process theory of clinical reasoning, which is often associated with better diagnostic competence. Developers of medical education curricula, therefore, should use heuristic techniques that trigger dual-process clinical reasoning.