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Pottier P, Planchon B. Les activités mentales au cours du raisonnement médical diagnostique. [Description of the mental processes occurring during clinical reasoning]. Rev Med Interne. 2010;32(6):383-90doi: 10.1016/j.revmed.2010.10.009.
Pottier, P., & Planchon, B. (2011). Les activités mentales au cours du raisonnement médical diagnostique. [Description of the mental processes occurring during clinical reasoning]. La Revue de medecine interne, 32(6), 383-90. https://doi.org/10.1016/j.revmed.2010.10.009
Pottier, P, and Planchon, B. "Les activités mentales au cours du raisonnement médical diagnostique." [Description of the mental processes occurring during clinical reasoning]. La Revue de medecine interne vol. 32,6 (2011): 383-90. doi: https://doi.org/10.1016/j.revmed.2010.10.009
Pottier P, Planchon B. Les activités mentales au cours du raisonnement médical diagnostique. [Description of the mental processes occurring during clinical reasoning]. Rev Med Interne. 2011 Jun;32(6):383-90. doi: 10.1016/j.revmed.2010.10.009. Epub 2010 Nov 17. French. PMID: 21087813.
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Rev Med Interne. 2011 Jun;32(6):383-90. doi: 10.1016/j.revmed.2010.10.009. Epub 2010 Nov 17.

[Description of the mental processes occurring during clinical reasoning].

La Revue de medecine interne

[Article in French]
P Pottier, B Planchon

Affiliations

  1. Service de médecine interne, Hôtel-Dieu, CHU de Nantes, place Alexis-Ricordeau, 44093 Nantes cedex 1, France. [email protected]

PMID: 21087813 DOI: 10.1016/j.revmed.2010.10.009

Abstract

Clinical reasoning is a highly complex system with multiple inter-dependent mental activities. Gaining a better understanding of those cognitive processes has two practical implications: for physicians, being able to analyse their own reasoning method may prove to be helpful in diagnostic dead end; for medical teachers, identifying problem-solving strategies used by medical students may foster an appropriate individual feed-back aiming at improving their clinical reasoning skills. On the basis of a detailed literature review, the main diagnostic strategies and their related pattern of mental processes are described and illustrated with a concrete example, going from the patient's complaint to the chosen solution. Inductive, abductive and deductive diagnostic approaches are detailed. Different strategies for collecting data (exhaustive or oriented) and for problem-building are described. The place of problem solving strategies such as pattern-recognition, scheme inductive process, using of clinical script, syndrome grouping and mental hypotheses test is considered. This work aims at breaking up mental activities in process within clinical reasoning reminding that expert reasoning is characterised by the ability to use and structure the whole of these activities in a coherent system, using combined strategies in order to guarantee a better accuracy of their diagnosis.

Copyright © 2010 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

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