Risk and Reasoning in Clinical Diagnosis is an accessible and readable look at the medical diagnostic process. Based on 30 years experience as a primary care clnician, the author presents insights and concepts developed in cognitive psychology that bear on the diagnostic process, reviews what recent evidence tells us about diagnosis, and suggests specific, practical steps aimed at improving diagnosis in medical training and practice.
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
This book offers a philosophically-based, yet clinically-oriented perspective on current medical reasoning aiming at 1) identifying important forms of uncertainty permeating current clinical reasoning and practice 2) promoting the application of an abductive methodology in the health context in order to deal with those clinical uncertainties 3) bridging the gap between biomedical knowledge, clinical practice, and research and values in both clinical and philosophical literature. With a clear philosophical emphasis, the book investigates themes lying at the border between several disciplines, such as medicine, nursing, logic, epistemology, and philosophy of science; but also ethics, epidemiology, and statistics. At the same time, it critically discusses and compares several professional approaches to clinical practice such as the one of medical doctors, nurses and other clinical practitioners, showing the need for developing a unified framework of reasoning, which merges methods and resources from many different clinical but also non-clinical disciplines. In particular, this book shows how to leverage nursing knowledge and practice, which has been considerably neglected so far, to further shape the interdisciplinary nature of clinical reasoning. Furthermore, a thorough philosophical investigation on the values involved in health care is provided, based on both the clinical and philosophical literature. The book concludes by proposing an integrative approach to health and disease going beyond the so-called "classical biomedical model of care".
This book is open access under a CC BY 4.0 license. This volume describes and explains the educational method of Case-Based Clinical Reasoning (CBCR) used successfully in medical schools to prepare students to think like doctors before they enter the clinical arena and become engaged in patient care. Although this approach poses the paradoxical problem of a lack of clinical experience that is so essential for building proficiency in clinical reasoning, CBCR is built on the premise that solving clinical problems involves the ability to reason about disease processes. This requires knowledge of anatomy and the working and pathology of organ systems, as well as the ability to regard patient problems as patterns and compare them with instances of illness scripts of patients the clinician has seen in the past and stored in memory. CBCR stimulates the development of early, rudimentary illness scripts through elaboration and systematic discussion of the courses of action from the initial presentation of the patient to the final steps of clinical management. The book combines general backgrounds of clinical reasoning education and assessment with a detailed elaboration of the CBCR method for application in any medical curriculum, either as a mandatory or as an elective course. It consists of three parts: a general introduction to clinical reasoning education, application of the CBCR method, and cases that can used by educators to try out this method.
This new manual offers readers valuable practice in analyzing data and making effective clinical decisions. First, a section on Clinical Data explores the decision-making process, the health history, the physical examination, diagnostic tests, and herbal therapies. Next, abundant case studies cover a variety of disorders in every body system. A final section on Documentation as a Communication Tool explains how to document care successfully.
ABC of Clinical Reasoning Being a good clinician is not only about knowledge — how doctors and other healthcare professionals think, reason, and make decisions is arguably their most critical skill. The second edition of the ABC of Clinical Reasoning breaks down clinical reasoning into its core components and explores each of these in more detail, including the applications for clinical practice, teaching, and learning. Informed by the latest evidence from cognitive psychology, education, and studies of expertise, this edition has been extensively re-written and updated, and covers: Key components of clinical reasoning: evidence-based history and examination, choosing and interpreting diagnostic tests, problem identification and management, and shared decision-making Key concepts in clinical reasoning, such dual process theories, and script theory Situativity and human factors Metacognition and cognitive strategies Teaching clinical reasoning From a team of expert authors, the ABC of Clinical Reasoning is essential reading for all students, clinical teachers, curriculum planners and clinicians involved in diagnosis. About the ABC series The ABC series has been designed to help you access information quickly and deliver the best patient care, and remains an essential reference tool for GPs, junior doctors, medical students and healthcare professionals. Now offering over 80 titles, this extensive series provides you with a quick and dependable reference on a range of topics in all the major specialties. The ABC series is the essential and dependable source of up-to-date information for all practitioners and students in primary healthcare. To receive automatic updates on books and journals in your specialty, join our email list. Sign up today at www.wiley.com/email
This handbook describes the diagnostic process clearly and logically, aiding medical students and others who wish to improve their diagnostic performance and to learn more about the diagnostic process.
Technology assessment can lead to the rapid application of essential diagnostic technologies and prevent the wide diffusion of marginally useful methods. In both of these ways, it can increase quality of care and decrease the cost of health care. This comprehensive monograph carefully explores methods of and barriers to diagnostic technology assessment and describes both the rationale and the guidelines for meaningful evaluation. While proposing a multi-institutional approach, it emphasizes some of the problems involved and defines a mechanism for improving the evaluation and use of medical technology and essential resources needed to enhance patient care.
Chapter topics include: Clinical Reasoning and Diagnostic Error Theoretical Concepts to Consider in Providing Clinical Reasoning Instruction Developing a Curriculum in Clinical Reasoning Educational Approaches to Common Cognitive Errors General Teaching Techniques Assessment of Clinical Reasoning Faculty Development and Dissemination Lifelong Learning in Clinical Reasoning Remediation of Clinical Reasoning Novel Approaches and Future Directions Teaching Clinical Reasoning: Where do we go from here?
