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Yazdani S, Hosseinzadeh M, Hosseini F. Models of clinical reasoning with a focus on general practice: A critical review. J Adv Med Educ Prof. 2017;5(4):177-184
Yazdani, S., Hosseinzadeh, M., & Hosseini, F. (2017). Models of clinical reasoning with a focus on general practice: A critical review. Journal of advances in medical education & professionalism, 5(4), 177-184.
Yazdani, Shahram, et al. "Models of clinical reasoning with a focus on general practice: A critical review." Journal of advances in medical education & professionalism vol. 5,4 (2017): 177-184.
Yazdani S, Hosseinzadeh M, Hosseini F. Models of clinical reasoning with a focus on general practice: A critical review. J Adv Med Educ Prof. 2017 Oct;5(4):177-184. PMID: 28979912; PMCID: PMC5611427.
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J Adv Med Educ Prof. 2017 Oct;5(4):177-184.

Models of clinical reasoning with a focus on general practice: A critical review.

Journal of advances in medical education & professionalism

Shahram Yazdani, Mohammad Hosseinzadeh, Fakhrolsadat Hosseini

Affiliations

  1. School of Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

PMID: 28979912 PMCID: PMC5611427

Abstract

INTRODUCTION: Diagnosis lies at the heart of general practice. Every day general practitioners (GPs) visit patients with a wide variety of complaints and concerns, with often minor but sometimes serious symptoms. General practice has many features which differentiate it from specialty care setting, but during the last four decades little attention was paid to clinical reasoning in general practice. Therefore, we aimed to critically review the clinical reasoning models with a focus on the clinical reasoning in general practice or clinical reasoning of general practitioners to find out to what extent the existing models explain the clinical reasoning specially in primary care and also identity the gaps of the model for use in primary care settings.

METHODS: A systematic search to find models of clinical reasoning were performed. To have more precision, we excluded the studies that focused on neurobiological aspects of reasoning, reasoning in disciplines other than medicine decision making or decision analysis on treatment or management plan. All the articles and documents were first scanned to see whether they include important relevant contents or any models. The selected studies which described a model of clinical reasoning in general practitioners or with a focus on general practice were then reviewed and appraisal or critics of other authors on these models were included. The reviewed documents on the model were synthesized.

RESULTS: Six models of clinical reasoning were identified including hypothetic-deductive model, pattern recognition, a dual process diagnostic reasoning model, pathway for clinical reasoning, an integrative model of clinical reasoning, and model of diagnostic reasoning strategies in primary care. Only one model had specifically focused on general practitioners reasoning.

CONCLUSION: A Model of clinical reasoning that included specific features of general practice to better help the general practitioners with the difficulties of clinical reasoning in this setting is needed.

Keywords: Diagnosis; General practitioners ; Problem solving

Conflict of interest statement

Conflict of interests: None declared.

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