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This assignment aims to examine the theory behind how clinical decisions are made and the key characteristics of clinical reasoning. The assignments objectives are to get you to consider how in practice clinical reasoning is applied. The assignment critiques a real world case that you have been involved with and targets key reasoning processes and factors that affect the delivery of care. The assignment gets you to search current literature to learn about intuitive reasoning, analytical reasoning, heuristics and cognitive function and how bias can influence decisions in the clinical setting.
- Critique clinical decisions made in practice.
- Demonstrate an introductory knowledge of intuitive and analytical reasoning.
- Identify and evaluate factors which influence clinical reasoning.
- Identify human and system factors which affect clinical decisions and how they are translated into practice.
- Understand the role of bias in clinical reasoning and decision making.
Choose a case that you have attended during your clinical placements (paramedic). Choose a case that was challenging. The challenges could be because of issues with:
- Treatment provision,
- Patient diagnosis or difficult signs and symptoms and comorbidities,
- Logistical or environmental factors which influenced treatment, transport and paramedic actions.
Briefly outline the case that you have chosen (100 words)
o Outline the key features of the case in the introduction.
- Answer the following questions
o The questions focus on the clinical reasoning used during the case and how decisions were made in the case.
o Support with reference to literature and evidence.
IMPORTANT!!CONFIDENTIALITY IS OF UTMOST IMPORTANCE. STRICTLY NO REFERENCE TO CREW, PATIENT OR HOSPITAL IDENTIFIERS, DATES, LOCATION OR PLACE NAMES.
SHORT ANSWER QUESTIONS
Define intuitive and analytical (hypothetico-deductive) reasoning and discuss how you believe they relate to the diagnosis and clinical decisions made in your case? • Describe how you think analytical (hypothetico-deductive) and intuitive reasoning may have influenced the diagnosis, the elimination of differential diagnoses and the way treatment (care) was provided. • Think about the idea of the Duel Process Theory!! Support your discussion using literature. (500 words – provide at least two (2) references to literature on intuitive & analytical reasoning) • Note: make sure in your response you describe both intuitive and analytical reasoning (their key feature and Include the idea of heuristics i.e. mental short cuts). • Link to how they were used to develop potential diagnoses and treatment pathways.
What influence would knowledge and clinical experience (scope of practice and education) have on the diagnostic process? • Include reference to the different types of bias and how they influence the decision making process. • Consider how information is gathered, valued and incorporated in decision making. • Choose the biases that are most relevant to your case. Support your answers using literature and reference to the case. (300 words – provide at least two (2) references to literature regrading bias in clinical reasoning) • Note: make sure you consider in your answer the difference between novice to expert clinician and how they are defined and the way education and knowledge influences clinical reasoning. • Consider in your answer how the way we think (cognitive bias) affects clinical reasoning.
Current literature points to a debate surrounding the reliability and safety of intuitive clinical reasoning in comparison to analytical (hypothetico-deductive) reasoning. Discuss the benefits and limitations of both forms of reasoning in relation to your case. Support your answers using literature and reference to the case. (300 words – provide at least two (2) references to literature regarding the benefits and limitations of both forms of reasoning) • Note: Include reference to the reliability of intuitive and analytical reasoning and why there are limitations to both forms of reasoning.
Describe two (2) key factors which might have influenced the clinical decisions and diagnosis made in your case. Discuss briefly why and how these factors influenced the clinical reasoning in your case. The following are suggested areas for consideration. a) Level of knowledge and experience of the clinician b) Patient presentation (clinical signs & symptoms) c) Safety & Harm – Clinical Outcomes d) Psychological / Social Factors e) Environmental Factors f) Operational & Logistical Factors (system factors) Support why these factors ‘bound’ or constrain the decision making in your case with reference to literature (300 words – provide at least two (2) references to literature regrading factors that influence clinical reasoning)