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Effective reasoning in clinical practice
Effective reasoning in clinical practice
Effective reasoning in clinical practice
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Clinical reasoning is the ability to 'sort through a cluster of features presented by a patient and accurately assign a diagnostic label, with the development of an appropriate treatment strategy as the end goal'.
It is central to our clinical practice, yet it remains an enigma and continues to present a challenge to teachers and learners. There are at least two reasons that make clinical reasoning problematic for clinicians. Firstly, experienced clinicians often use rapid unconscious cognitive reasoning processes and find it difficult to slow down and explain how they are thinking.
Secondly, the articles on clinical reasoning are not normally published in the journals clinicians commonly read but instead are in the medical education, cognitive
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Based on the previously collected data, the therapist accurately assigns a problem list, with the development of an appropriate diagnosis and treatment strategy as the end goal. It is the core of every clinical practice, yet it remains as a puzzle and continues to present a challenge to both educators and students. Although this method is widely used but the experience clinicians often use rapid unconscious cognitive reasoning processes and find it hard to justify how they were thinking. Also, there is not enough information regarding the clinical reasoning normally published in the Journals clinicians commonly read as in the medical education, cognitive psychology or sociology literature (Pinnock & Welch …show more content…
Examples of these reasoning strategies include comparing, error analysis, constructing support, analyzing perspectives, decision- making, investigation, experimental inquiry, problem- solving, and invention. These strategies encourage students to use their clinical reasoning more effectively. In reference to a meta-analysis study, done by (Wang J. et al, 2016) comparing the PBL and traditional curricula for clinical performance in some third-year medical students, the results indicated that the preclinical PBL enhanced third-year students' clinical
In psychology, there are various schools of thought when approaching a particular psychological problem. Each may view the scenario from a different avenue of approach, and their methods and techniques used to treat the problem may also vary. This paper will discuss case scenario three, involving a man named John who appears to be exhibiting obsessive-compulsive disorder (OCD). With this example, the paper will discuss the various schools of thought in psychological theory, their techniques, and recommendations for treatment; to include how this knowledge could be applied to my current professional work.
This essay will demonstrate an understanding of the clinical reasoning cycle which describes the procedure by which nurses gather prompts, process the data, come to an understanding of a patient’s problem, design and implement interventions, assess results, and reflect on and learn from the process (Hoffman, 2007; Kraischsk & Anthony, 2001; Laurie et al., 2001). The clinical reasoning cycle consists of five main stages, it comprises of; considering the persons condition, collecting indications and data, processing the information, recognizing problems/issues and detailing the assessment (Levett-Jones 2013). Throughout this essay these five main parts of the clinical reasoning cycle will be discussed and put into context. The first step of
Case conceptualization and treatment planning is used by therapist to assist in determining a client’s diagnosis, goals, and treatment plan that is most effective in determining the issues surrounding the clients diagnosis. It is crucial that the client’s treatment plan is specific to the individual, is relational and appropriate to the needs of the client.
Today’s clinical experience truly affected me in multiple ways. I went into this day with an open mind, and was pleased with the patients and the way I was able to conduct myself. This clinical affected me because throughout the day I felt that I experienced many emotions. A few times during my day I did have to fight back tears. I felt I had this emotion because some of the individuals expressed how they wanted to get better in order to get home to their families.
Define a critical thinking task that your staff does frequently (Examples: treat high blood sugar, address low blood pressure, pain management, treat fever, etc.). Create a concept map or flow chart of the critical thinking process nurses should take to determine the correct intervention. Include how much autonomy a nurse should have to apply personal wisdom to the process. If the critical thinking process was automated, list two instances where a nurse may use “wisdom” to override the automated outcome suggested. Note the risks and benefits of using clinical decision-making systems.
Look back: During my third week clinical experience, I did both computer charting and paper charting (for maternal assessment) with nursing care plan. Besides charting, I reported my significant findings of the mother verbally to the primary nurse.
Critical thinking and clinical judgment are important skills that professional nurses use in every day clinical setting. In 2012, a mix method qualitative study by Dr. Jeanne Mann was done to evaluate the effectiveness of educational strategy to develop clinical judgment skills in nursing students. In this study, the population was identified as volunteered Level II baccalaureate nursing students from a Midwest nursing program. The variables identified in this article are the relation between critical thinking and clinical judgment. The title of the article clearly indicated the focus of the study and created an interest in reading the research due to nurses utilize their ability to critical think and clinical judgment in all aspect of their practice.
Throughout this program, this author has learned the various ways critical thinking is utilized in nursing. This applies to developing care maps, Kaplan testing, using the nursing process, medication administration, and patient care. Kaplan testing has been the hardest aspect of thinking critically for this author. However, with practice and remediation, this author has learned how to critically think through the questions in order to choose the best possible answer. In correlation, this author now understands that thinking critically leads to effective, high-quality care and patient outcomes by understanding the needs of patients and treating those patients with evidence-based care.
Implementing the terms that encompass clinical reasoning will teach students to take all aspects of each patient into account and will follow the occupational therapy holistic approach. The elements that make up clinical reasoning as a whole are narrative reasoning, interactive reasoning, procedural reasoning, pragmatic reasoning, and conditional reasoning (Neistadt, 1996).
Cognitive therapy recognizes ten common patterns of faulty thinking. “All-or-nothing thinking” refuses to see a middle ground and is characterized by the use of such words as always, never, and forever. This pattern can be recognized by statements such as “I will never pass this class”.
Cognitive behavioral theory should also be used to assist this client. Cognitive Behavioral Therapy states that an individual’s problems stem from dysfunctional cognitive processing. In this type of therapy, the therapist attempts to help the client correct a variety of irrational and self-blaming thoughts and tendencies that the client possesses. The therapist then helps the client see how irrational thoughts, beliefs, and behaviors affect the progression of their problems. This therapy focuses on achieving both short and long-term goals in order to help the client. This type of therapy also utilizes the ABC Model. This model emphasizes that an activating event leads to an often self-blaming belief, which can then have a variety of consequences
Cognitive psychologists investigate processes using case studies of brain-damaged patients, these are then analysed to build models that represent normal cognitive processes. This essay will examine the contribution case studies have made to the development of cognitive neuropsychology as a discipline in its own right and draw attention to issues surrounding the use of brain damaged patients to infer cognitive functions and processes. At the same time, it will evaluate the contribution that case studies have made to our understanding of cognitive processes.
Lunney, M. (2010). Use of critical thinking in the diagnostic process. International Journal Of Nursing Terminologies & Classifications,21(2), 82-88. doi:10.1111/j.1744-618X.2010.01150.x
Initially developed by Aaron Beck in the 1960s, Cognitive Behavioral Therapy (CBT) also referred to as Cognitive Therapy (CT) focuses on understanding a client’s behaviors and feelings through focusing on their underlying cognitions and thoughts (Weinrach, 1988, p.159). Aaron Beck believed that our thoughts impact our feelings and in order to change negative feelings, we must identify and modify our dysfunctional thoughts (Weinrach,1988). A client’s symptoms or dysfunctional behaviors do not take place due to a situation or their feelings. Instead, Beck explains that between the situations or events and the emotional responses and behaviors, a conscious stream of thoughts take place (Craske, 2010). CBT explains human nature with an anti-deterministic
This reflective essay will discuss three skills that I have leant and developed during my placement. The three skills that I will be discussing in this essay are bed-bath, observing a corpse being prepared for mortuary and putting canulla and taking it out. These skills will be discussed in this essay using (Gibb’s, 1988) model. I have chosen to use Gibb’s model because I find this model easier to use and understand to guide me through my reflection process. Moreover, this model will be useful in breaking the new skills that I have developed into a way that I can understand. This model will also enable me to turn my experiences into knowledge that I can refer to in the future when facing same or similar situations. Gibbs model seems to be straightforward compared to the other model which is why I have also chosen it. To abide by the code of conduct of Nursing and Midwifery Council (NMC) names of the real patients in this essay have been changed to respect the confidentiality.