BMJ 2004;328:946 (17 April), doi:10.1136/bmj.328.7445.946
Commentary
Clinical reasoning
Ed Peile, professor of medical education1
1 Division of Medical Education, Warwick Medical School, University of Warwick, Coventry CV4 7AL ed.peile@warwick.ac.uk
| The first 150 words of the full text of this article appear below. |
Many BMJ readers have participated in the web discussion of this evolving case presentation and have been intrigued by the complexities of diagnosis. Initially, there was consensus around the broad diagnosis of heart failure, but responding to the twists and turns of the evolving clinical story, many medical readers showed traits of the amateur detective and the crossword puzzle enthusiast. It was this that led me to comment favourably on the learning to be had from doctors interacting with one another's clinical reasoning processes. I hope that the trend away from just submitting answers in a right or wrong format towards exposing the workings of our medical minds will continue.
What is clinical reasoning? The process by which doctors funnel their thinking towards probable diagnosis is classically thought of as a mixture of pattern recognition and "hypothetico-deductive" reasoning.1
2 The reasoning process depends on medical knowledge in areas such as disease
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