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Clinical Reasoning in the Health Professions E-Book

BOOK

Clinical Reasoning in the Health Professions E-Book

Joy Higgs | Gail M. Jensen | Stephen Loftus | Nicole Christensen

(2018)

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Additional Information

Book Details

ISBN
978-0-7020-6505-7
Edition
4
Language
English
Pages
532
Subjects
Cardiovascular medicine
Sports injuries & medicine
Therapy & therapeutics
Chiropody & podiatry
Occupational therapy
Rehabilitation
Medical study & revision guides & reference material
Chiropractic & osteopathy

Abstract

Clinical reasoning lies at the core of health care practice and education. Clinical Reasoning in the Health Professions, therefore, occupies a central place in the education of health professionals, the enhancement of professional decision making of individuals and groups of practitioners with their clients, and research into optimal practice reasoning.

    All chapters updated and 20 new chapters added

    Concrete examples, cases and vignettes were added to bring discussions to life for the reader

    Reflection points strategically placed to assist readers to extend their insights and build learning from their own practical experiences and theoretical knowledge

    Devices of particular value to reflective practitioners and educators

    All chapters updated and 20 new chapters added

    Concrete examples, cases and vignettes were added to bring discussions to life for the reader

    Reflection points strategically placed to assist readers to extend their insights and build learning from their own practical experiences and theoretical knowledge

    Devices of particular value to reflective practitioners and educators.


    Table of Contents

    Section Title Page Action Price
    Front Cover cover
    Clinical Reasoning in the Health Professions i
    Copyright Page iv
    Table Of Contents v
    Preface ix
    Clinical Reasoning as the Core of Professional Practice ix
    The Context of Clinical Reasoning x
    Collaborative and Transdisciplinary Reasoning x
    Reasoning Across the Professions x
    Teaching Clinical Reasoning xi
    Learning Clinical Reasoning xi
    List of Contributors xiii
    Acknowledgements xix
    1 Understanding Clinical Reasoning 1
    1 Clinical Reasoning 3
    Chapter Aims 3
    Key Words 3
    Understanding Clinical Reasoning 3
    Challenges Faced by People Engaged in Clinical Decision Making 4
    Challenges of Dealing With a Complex World 4
    Challenges in Addressing Wicked Problems and Accountability 5
    Challenges of Making Complex and Consequential Decisions 6
    Challenges in Sharing Decision-Making Processes and Outcomes 8
    Challenges Faced by People Engaged in Learning and Teaching Clinical Reasoning 9
    Building Clinical Reasoning Into Curricula 9
    Teaching and Learning Clinical Reasoning Complexities 9
    Learning Something That’s Not Simply Black and White 9
    Chapter Summary 10
    References 11
    2 Re-Interpreting Clinical Reasoning 13
    Chapter Aims 13
    Key Words 13
    Re-Interpreting Clinical Reasoning 13
    Clinical Reasoning as an Encultured Practice 14
    Culture 14
    Socio-Political and Institutional Cultures Affecting the World of Healthcare Practice 15
    Client Health and Well-Being Narratives and Horizons 15
    Professional Practice 16
    Communities of Practice 16
    Professionalization and Professional Socialization 16
    Understanding Professional Practice Paradigms 17
    Clinical Reasoning and Knowing in Practice 19
    Professional Practice Knowledge 20
    Developing Intellectual Virtues 21
    Epistemic Cultures 21
    Epistemic Fluency 24
    Developing Epistemic Fluency and Reasoning Conversation Capability 24
    Pursuing Clinical Reasoning Capability 25
    ReDefining Clinical Reasoning as A Range of Encultured Decision-Making Capabilities 26
    A Revised Interpretation of Clinical Reasoning and Decision Making 27
    A Model of Clinical Reasoning as Encultured Decision-Making Capabilities 28
    Chapter Summary 29
    References 30
    3 Multiple Spaces of Choice, Engagement and Influence in Clinical Decision Making 33
    Chapter Aims 33
    Key Words 33
    Abbreviations/Acronyms 33
    Introduction 33
    Clinical Reasoning Spaces From the Inside Out 33
    Client Spaces 33
    Practitioner Spaces 35
    The Collaborative Problem Space of the Team 35
    The Problem Space of the Workplace and the Local System 35
    The Knowledge-Reasoning Space of Clinical Decision Making 35
    The Problem Space of the Global Health Care System With Its Discourse, Knowledge and Technology 36
    Errors 36
    Clinical Reasoning Strategies 37
    Examining the Range of Clinical Reasoning Strategies 37
    Factors Influencing Choices About Clinical Reasoning Strategies 37
    Selecting a Reasoning Approach 39
    Professional Development of Clinical Reasoning Capability 40
    Chapter Summary 42
    References 42
    4 Clinical Reasoning and Models of Practice 45
    Chapter Aims 45
    Key Words 45
    Introduction 45
    Recognizing Our Practice Context and Influences 45
    Understanding and Valuing Interests and Priorities 46
    The Social and Historical Construction of Practice Approaches 46
    The Shaping of Practice Models: The Place of Ideology 47
    Workplace Influences 47
    Working Across and Within Different Practice Communities 47
    Being Deliberate: Making Choices About Our Practice Models 48
    Models of Practice 48
    Reasoning in a Critical Social Science Model for Practice 50
    The CSS Model 51
    An Emancipatory Dimension 51
    A Critical, Lived Dimension 53
    Chapter Summary 54
    References 55
    5 The Development of Clinical Reasoning Expertise 57
    Chapter Aims 57
    Key Words 57
    Introduction 57
    A Theory of the Development of Medical Expertise 57
    Teaching Clinical Reasoning 61
    Chapter Summary 64
    References 65
    6 Expertise and Clinical Reasoning 67
    Chapter Aims 67
    Key Words 67
    Introduction 67
    Deconstructing the Interrelated Concepts of Expertise and Clinical Reasoning 68
    Expertise as Mental Processing and Problem Solving 68
    Expertise as Skill Acquisition 68
    Key Elements in Expertise and Adaptive Expertise 69
    Expertise and Clinical Reasoning in Everyday Practice 71
    Clinical Reasoning and Novice Development: Developing Habits of Mind 73
    Chapter Summary 74
    References 75
    2 The Changing Context of Clinical Reasoning and Practice 77
    7 The Context of Clinical Reasoning Across the Health Professions in the 21St Century 79
    Chapter Aims 79
    Key Words 79
    Abbreviations/Acronyms 79
    Introduction 79
    Shifting Contexts and Identities 81
    Clinical Reasoning: Valuing Evidence 82
    Critical Reflexivity and ‘Negotiation’ 84
    Chapter Summary 84
    References 85
    8 Changing Demographic and Cultural Dimensions of Populations 87
    Chapter Aims 87
    Key Words 87
    Introduction 87
    Changing Populations 88
    Changing Populations and Clinical Reasoning 89
    Epidemiological Complexity, Aging and Clinical Reasoning 90
    Cultural Complexity, Race/Ethnic Diversification and Clinical Reasoning 92
    Clinical Reasoning in a Postindustrial World 94
    Conclusion 95
    Chapter Summary 95
    References 95
    9 Clinical Thinking, Client Expectations and Patient-Centred Care 97
    Chapter Aims 97
    Key Words 97
    Abbreviations/Acronyms 97
    Introduction 97
    Current Conceptions of Client Expectations and Patient-Centred Care 97
    How Healthcare Professionals Think: The Central Expertise of HCPs Needs to be Better Understood by Patients 99
    The Importance of the Nature of the HCP’s Professionalism: Uncovering Its Transformative Potential 100
    Four Current Ways of Seeing Professionalism 101
    Transformative Professionalism 104
    Chapter Summary 105
    References 106
    10 Next-Generation Clinical Practice Guidelines 109
    Chapter Aims 109
    Key Words 109
    Abbreviations/Acronyms 109
    Introduction 109
    Frameworks of Clinical Practice Guidelines Application 109
    Current State of Play in Clinical Practice Guidelines 110
    Critical Elements of Using Clinical Practice Guidelines 111
    Next-Generation Clinical Practice Guidelines 111
    Implementation 112
    Clinical Practice Guideline Adoption 113
    Clinical Practice Guideline Contextualization 113
    Clinical Practice Guideline Adaptation 113
    Consumer Engagement 114
    Clinical Practice Guidelines, Clinical Reasoning and Patient Outcomes 114
    The Future 115
    Chapter Summary 116
    References 116
    11 Action and Narrative 119
    Chapter Aims 119
    Key Words 119
    Introduction 119
    Action and Judgement 119
    Tacit Knowledge and Professional Judgement 121
    Narrative Reasoning 121
    Prospective Stories: Therapy and Life Stories 123
    Active Judgements, Tacit Knowledge and Narrative Images: a Case Story 124
    Action, Judgement, Narrative and Expertise in Ann’s Story 124
    Chapter Summary 127
    References 127
    12 The Language of Clinical Reasoning 129
    Chapter Aims 129
    Key Words 129
    Introduction 129
    Metaphor 130
    New Metaphors in Clinical Reasoning 131
    Narrative 133
    Rhetoric 133
    Chapter Summary 135
    References 135
    13 Evidence-Based Practice and Clinical Reasoning 137
    Chapter Aims 137
    Key Words 137
    Abbreviations/Acronyms 137
    Introduction 137
    Section 1: Evidence-Based Practice Is a Contributor to Clinical Reasoning 139
    Areas for Future Research 141
    Section 2: Evidence-Based Practice Is the Way in Which Clinical Reasoning Unfolds or Should Unfold 142
    Areas for Future Research 143
    Section 3: Evidence-Based Practice and Clinical Reasoning Are Different Words/Frames for the ‘Same Thing’ 144
    Areas for Future Research 145
    Chapter Summary 145
    References 145
    14 Methods in the Study of Clinical Reasoning 147
    Chapter Aims 147
    Key Words 147
    Introduction 147
    Quantitative Methods 148
    The Script Concordance Test 148
    The Repertory Grid Technique 148
    Neuro-Imaging Methods 149
    Eye Tracking 150
    Qualitative Methods 150
    Verbal Protocols 150
    Think-Aloud Protocol and Analysis 150
    Explanation Protocols 151
    Video Data Collection and Analysis 152
    Conclusion 153
    Chapter Summary 154
    References 154
    3 Collaborative and Transdisciplinary Reasoning 157
    15 Collaborative Decision Making in Liquid Times 159
    Chapter Aims 159
    Key Words 159
    Introduction 159
    New Conditions of Decision-Making Processes in Liquid Times 159
    Conceptual Perspectives and Principles of Collaborative Decision Making 161
    Readiness for Collaborative Decision Making Is Not a Given 161
    Agreement to Participate in Collaborative Decision Making Needs to Be Checked via Informed Consent 161
    Many Factors Influence Patients’ Agreements About Decisions – Yes May Not Mean (Informed) Yes 162
    Agreement May Be Apparent and Unchallenged Rather Than Genuine and Empowered 162
    Conceptual Models of Shared Decision Making 162
    The Primacy of Interests: a Critical Model for Collaborative Decision Making 163
    Operationalizing Collaborative Decision Making 164
    The Uninformed 164
    The Unconvinced 164
    The Contemplators 165
    The Transformers 165
    The Champions 166
    Chapter Summary 167
    References 167
    16 Ethical Reasoning 169
    Chapter Aims 169
    Key Words 169
    Abbreviations/Acronyms 169
    Introduction 169
    The Ethical Reasoning Bridge 171
    Normative and Nonnormative Ethics 171
    The Social Formation of Ethical Reasoning 172
    Moral Identity and Agency 175
    Chapter Summary 178
    References 178
    17 Shared Decision Making in Practice 181
    Chapter Aims 181
    Key Words 181
    Abbreviations/Acronyms 181
    Introduction 181
    Shared Decision Making 181
    Attributes of Shared Decision Making 182
    Barriers to Shared Decision Making 183
    Shared Decision Making in Practice 183
    Cultural Influences: Individual and Organizational on Shared Decision Making 183
    Interprofessional Collaborative Practice and Shared Decision Making 185
    Implementation of the Interprofessional Shared Decision-Making (IP-SDM) Model 186
    Important Influences for Successful Implementation and Sustainability of Shared Decision Making 187
    Electronic Health Records for Successful Implementation and Sustainability of Shared Decision Making 187
    Decisional Aids for Successful Implementation and Sustainability of Shared Decision Making 187
    Outcomes of Shared Decision Making 187
    Chapter Summary 188
    References 189
    18 Using Decision Aids to Involve Clients in Clinical Decision Making 191
    Chapter Aims 191
    Key Words 191
    Abbreviations 191
    Introduction 191
    What Is A Patient Decision Aid? 191
    When Should You Consider Using a Decision Aid? 192
    How Do Decision Aids Work? 194
    What Makes a ‘Good’ Decision Aid? 195
    Where Can You Find Patient Decision Aids? 196
    What Is the Best Way to Involve Clients in Using Decision Aids? 196
    What Should I Do if I Cannot Find a Relevant Decision Aid? 196
    How Can the Health Team Play a Role? 197
    Can Patient Decision Aids Be Used to Involve Family Members and Carers? 197
    Can Patients From Vulnerable Populations Benefit From Using Patient Decision Aids? 198
    Chapter Summary 198
    References 198
    19 Clinical Decision Making, Social Justice and Client empowerment 201
    Chapter Aims 201
    Key Words 201
    Introduction 201
    Social Determinants of Health 201
    Social Justice 204
    Empowerment 207
    Chapter Summary 208
    References 208
    20 Clinical Decision Making Across Orthodox and Complementary Medicine Fields 211
    Chapter Aims 211
    Key Words 211
    Abbreviations/Acronyms 211
    Introduction 211
    Alternative Ways of Thinking Through Clinical Problems 213
    Integrating Alternative Ways of Thinking With the Thinking of Mainstream Allopathic Medicine 214
    Models of Integration 215
    Pluralism 215
    Harmonization 215
    Integration 216
    Integrated Clinical Reasoning 216
    Chapter Summary 217
    References 218
    4 Clinical Reasoning and the Professions 221
    21 Clinical Reasoning in Medicine 223
    Chapter Aims 223
    Key Words 223
    Abbreviations/Acronyms 223
    Introduction 223
    A Common Basis: Dual-Process Theory 224
    Problem Solving: Diagnosis as Hypotheses Generation and Selection 224
    The Hypothetico-Deductive Method 224
    Early Hypothesis Generation and Selective Data Collection 224
    Data Collection and Interpretation 225
    Case Specificity 225
    Diagnosis as Categorization or Pattern Recognition 226
    Multiple Reasoning Strategies 226
    Decision Making: Diagnosis as Opinion Revision 227
    A Common Challenge: Diagnostic Error 227
    Errors in Hypothesis Generation and Restructuring 228
    Errors in Data Interpretation 228
    Errors in Probability Estimation 229
    Errors in Probability Revision 229
    Conservatism 229
    Confounding Probability and Value of an Outcome 230
    Base-Rate Neglect 230
    Order Effects 230
    Educational Implications 230
    Problem Solving: Educational Implications 230
    Decision Making: Educational Implications 231
    Evidence-Based Medicine 231
    Decision Support Systems 231
    Debiasing 231
    Embracing System 1 232
    Chapter Summary 232
    References 233
    22 Clinical Reasoning in Nursing 235
    Chapter Aims 235
    Key Words 235
    Abbreviations/Acronyms 235
    Introduction 235
    Definition of Clinical Reasoning 236
    Theoretical Perspectives 236
    Information Processing Theory 236
    Decision Analysis Theory 236
    Hermeneutics and Heuristics 237
    Clinical Judgement Studies 237
    Problem-Solving and Decision-Making Studies 238
    Intuition Studies 238
    Diagnostic Reasoning Studies 238
    Diagnostic Errors in Clinical Reasoning and Preventing 240
    Educational Focus on Clinical Reasoning 241
    Practice 243
    Future Directions in Practice Related to Nurses’ Clinical Reasoning 244
    Chapter Summary 244
    References 244
    23 Clinical Reasoning in Physiotherapy 247
    Chapter Aims 247
    Key Words 247
    Abbreviations/Acronyms 247
    Introduction 247
    Why Do Physiotherapists Need to Study and Practice Clinical Reasoning? 248
    Research Evidence Only Provides a Guide, Not a Prescription, to Practice 248
    Human Judgement Is Prone to Error 248
    Fast and Slow Reasoning in Physiotherapy Practice 249
    Three Frameworks to Situate Clinical Reasoning in Physiotherapy 250
    Clinical Reasoning in a Biopsychosocial Framework 250
    Focus of Our Clinical Reasoning: Clinical Reasoning Strategies 251
    Categories of Clinical Judgements Required: Hypothesis Categories 253
    Factors Influencing Clinical Reasoning 256
    Critical Thinking 256
    Metacognition 256
    Data Collection and Procedural Skills 257
    Knowledge Organization 257
    Therapeutic Alliance 258
    Chapter Summary 259
    References 259
    24 Clinical Reasoning in Dentistry 261
    Chapter Aims 261
    Key Words 261
    Abbreviations/Acronyms 261
    Evolution of Clinical Reasoning 261
    Exploring Clinical Reasoning 262
    Conceptual Framework 263
    Processes of Clinical Reasoning 264
    Ritual 264
    Backward (Deductive) and Forward (Inductive) Reasoning 264
    Pattern-Recognition Through Scripts 264
    Decision Analysis 264
    Clinical Reasoning Strategies 264
    Scientific Reasoning 264
    Conditional Reasoning 264
    Collaborative Reasoning 265
    Narrative Reasoning 265
    Ethical Reasoning 265
    Pragmatic Reasoning 265
    Part-Whole Reasoning 265
    Key Features in Clinical Reasoning of Dentists 265
    Uncertainties in Clinical Reasoning 266
    Assessment of Clinical Reasoning 267
    Chapter Summary 268
    References 268
    25 Clinical Reasoning in Occupational Therapy 271
    Chapter Aims 271
    Key Words 271
    Abbreviations/Acronyms 271
    Introduction 271
    Clinical Reasoning in Occupational Therapy: Historical Perspective 272
    Knowledge and Clinical Reasoning in Occupational Therapy 273
    The Therapy Context 273
    Clients and Their Life Contexts 273
    Theory and Science 274
    Personal Beliefs of the Therapist 274
    Attitude-Behaviour Expectancy 274
    Personal Internal Frame of Reference 274
    Lines of Reasoning 275
    Scientific Reasoning: “What Is the Presenting Problem?” 275
    Narrative and Interactive Reasoning: “What Does It Mean to the Person?” 275
    Ethical Reasoning: “What Should Happen?” 275
    Conditional Reasoning: “What Will Be the Outcome?” 276
    Pragmatic Reasoning: “What Can Be Done?” 277
    Information Processing, Cognitive Strategy Use and Clinical Reasoning 277
    Perceive Strategies: Attention and Sensory Perception Strategies (Strategies for Attending to and Sensing Information) 279
    Recall Strategies (Strategies to ‘Know’ and Use What Is Known) 279
    Factual Knowledge (Facts) –‘Do I Know WHAT…?’ 280
    Schematic Knowledge (Schemes) –‘Do I Know WHERE…?’; ‘Do I Know WHEN…?’; ‘Do I Know HOW LONG…?’ 280
    Procedural Knowledge – ‘Do I Know HOW…?’ 280
    Plan Strategies (Strategies to Map Out, Program and Evaluate Future Action) 280
    Perform Strategies (Strategies Used to Time, Control and Monitor Therapy) 281
    Chapter Summary 281
    References 281
    26 Clinical Decision Making in Emergency Medicine 285
    Chapter Aims 285
    Key Words 285
    Abbreviations/Acronyms 285
    Introduction 285
    Emergence of Dual-Process Theory in Clinical Decision Making 286
    Rationality in Clinical Decision Making 286
    Facilitators of Rationality 287
    Dysrationalia 288
    How Does CDM in Emergency Medicine Differ From That in Other Settings? 292
    Chapter Summary 293
    References 294
    27 Clinical Decision Making in Paramedicine 295
    Chapter Aims 295
    Key Words 295
    Abbreviations/Acronyms 295
    Introduction 295
    The Nature of Paramedic Practice 296
    Clinical Reasoning in Paramedicine Practice 297
    Cognitive Strategies Involved in Clinical Reasoning 297
    Errors in Clinical Reasoning 298
    Educational Strategies to Improve Clinical Reasoning 299
    Chapter Summary 300
    References 301
    28 Clinical Decision Making in Optometry 303
    Chapter Aims 303
    Key Words 303
    Abbreviations/Acronyms 303
    Optometry and Its Scope of Practice 303
    Evidence-Based Decision Making in Optometry 305
    Evidence and Its Quality 305
    Basis of Optometrists’ Clinical Decision Making 307
    From Decision Making to Clinical Reasoning 308
    Scripts Formation and Activation 309
    Dual-Process Reasoning 310
    Conclusion 310
    Chapter Summary 310
    References 311
    29 Clinical Reasoning in Dietetics 313
    Chapter Aims 313
    Key Words 313
    Abbreviations/Acronyms 313
    Introduction 313
    The Context of Dietetics 314
    Clinical Reasoning in Clinical Dietetics 315
    Knowledge 315
    Cognition 316
    Metacognition 317
    Collaborative Decision Making in Dietetics 318
    Clinical Reasoning in Advanced Dietetic Practice 319
    Chapter Summary 321
    References 321
    30 Clinical Reasoning in Pharmacy 323
    Chapter Aims 323
    Key Words 323
    Introduction 323
    The Pharmacist as Part of A Collaborative Team 324
    Clinical Problem Solving for the Pharmacist 324
    The Collection and Assessment of Patient Information 325
    Collection 325
    Assessment 325
    Reasoning in the Collection-Assessment Phase 326
    Care Plan Development, Implementation and Follow-up: the Therapeutic Phase 327
    Planning 327
    Implementation 327
    Follow-up: Monitoring and Evaluation 328
    Reasoning in the Therapeutic Phase 329
    Common Sources of Reasoning Errors 329
    Inadequate Knowledge 330
    Cognitive Biases 330
    Chapter Summary 331
    References 331
    5 Teaching Clinical Reasoning 333
    31 Pedagogies for Teaching and Learning Clinical Reasoning 335
    Chapter Aims 335
    Key Words 335
    What Is Clinical Reasoning? 335
    Embodied Nature of Clinical Reasoning 336
    Situated Nature of Clinical Reasoning 337
    Pedagogies for Teaching Clinical Reasoning 338
    Teaching Clinical Reasoning in Classrooms 340
    Teaching Clinical Reasoning in Workplaces 341
    Future Directions 342
    Chapter Summary 343
    References 344
    32 Teaching Clinical Reasoning in Medical Education Courses 345
    Chapter Aims 345
    Key Words 345
    Abbreviations/Acronyms 345
    Introduction 345
    Understanding Reasoning 346
    Science of Reasoning 346
    Learning Goals 346
    Teaching Strategies 346
    Vocabulary of Reasoning 346
    Learning Goals 347
    Teaching Strategies 348
    Map of the Reasoning Process 348
    Learning Goals 349
    Teaching Strategies 350
    Integration 351
    Integration With Medical Knowledge Acquisition 351
    Learning Goals 351
    Teaching Strategies 352
    Integration With Hypothesis-Driven Data Collection 353
    6 Learning Clinical Reasoning 417
    39 Learning to Communicate Clinical Reasoning 419
    Chapter Aims 419
    Key Words 419
    Abbreviations/Acronyms 419
    Introduction 419
    Communication of Clinical Reasoning 420
    Learning to Communicate Clinical Reasoning: What’s Involved? 420
    Researching Reasoning and Communication 421
    Implications for University Curricula 421
    Implications for Workplace Learning 422
    Implications for Faculty Development 423
    Chapter Summary 424
    References 424
    40 Developing Clinical Reasoning Capability 427
    Chapter Aims 427
    Key Words 427
    Introduction 427
    Capability as A Learning Outcome 427
    Adaptive Learners 428
    Clinical Reasoning Capability 428
    Essential Thinking and Experiential Learning Skills for Clinical Reasoning Capability 429
    Reflective Thinking 429
    Critical Thinking 430
    Complexity Thinking 430
    Dialectical Thinking 431
    Facilitating Clinical Reasoning Capability and Adaptive Expertise 431
    Future Implications 431
    Chapter Summary 432
    References 433
    41 Remediating Learning and Performance of Reasoning 435
    Chapter Aims 435
    Key Words 435
    Abbreviations/Acronyms 435
    Can Clinical Reasoning Be Learned? 435
    Identification of Students Who Struggle With Clinical Reasoning 436
    Understanding Struggling Learners 436
    Unique Challenges to Learning Clinical Reasoning 438
    An Approach to the Remediation of Clinical Reasoning 438
    A Step-by-Step Approach to the Remediation of Clinical Reasoning 439
    Using the Tools and Grids in the Clinical Environment 441
    Chapter Summary 442
    References 443
    42 Learning About Factors Influencing Clinical Decision Making 445
    Chapter Aims 445
    Key Words 445
    Introduction 445
    Clinical Decision Making 445
    Factors Influencing Decision Making 446
    A Model of Factors Influencing Clinical Decision Making 446
    Learning to Identify and Integrate Strategies for Dealing With Clinical Task Complexity Into Decision Making 447
    Learning About Your Capabilities and Experience as a Decision Maker 449
    Learning About the External Context and Decision-Making Environments 451
    Chapter Summary 452
    Acknowledgement 454
    References 454
    43 Learning Reasoning Using Simulation 455
    Chapter Aims 455
    Key Words 455
    Abbreviations/Acronyms 455
    Introduction 455
    What Is Simulation-Based Learning? 456
    Types of Simulation 456
    Manikin-Based Simulation 456
    Standardized Patient Simulation 456
    Hybrid Simulation 457
    Mixed-Methods Simulation 457
    Procedural Simulation 457
    Computer-Based Simulation (Also Referred to As Screen-Based Simulation) 457
    Virtual Reality and Virtual World Simulation 458
    Facilitating Clinical Reasoning Development Through Simulation-Based Learning 459
    Cognitive Load Considerations for Simulation-Based Learning 460
    Future Implications 463
    Chapter Summary 463
    References 463
    44 Learning to Use Evidence to Support Decision Making 465
    Chapter Aims 465
    Key Words 465
    Abbreviations/Acronyms 465
    Introduction 465
    Understanding Evidence-Based Practice 465
    What Constitutes Evidence? 466
    The Evidence-Based Practice Movement’s Concept of Evidence 466
    Knowledge Paradigms and Evidence 467
    Types of Knowledge 467
    Types of Evidence 467
    Considering Evidence From the Patient’s Perspective 468
    Evidence-Based Practice and Clinical Reasoning 469
    Professional Expertise and Clinical Reasoning 470
    Making Decisions in Conditions Where Knowledge Is Uncertain 471
    Combining Art and Science in Credible Evidence-Based Practice 471
    Making Practice Evidence-Based and Reasoning-Sound 471
    Chapter Summary 472
    References 472
    45 Learning to Research Clinical Reasoning 475
    Chapter Aims 475
    Key Words 475
    Abbreviations/Acronyms 475
    Introduction 475
    Develop a Research Question 476
    Identify a Conceptual Framework 476
    Step 1: Get a Central Focus 477
    Step 2: Set Boundaries for the Framework 477
    Step 3: Look to the Literature for Research and Theory 477
    Step 4: Make a Visual, One-Page Framework 477
    Select the Research Designs and Methods 478
    Develop the Research Design 478
    Conclusion 481
    Chapter Summary 481
    References 482
    46 Learning Clinical Reasoning Across Cultural Contexts 483
    Chapter Aims 483
    Key Words 483
    Introduction 483
    Professional Culture and Language 484
    Culture, Context and Professional Practice 484
    What Is Cultural Competence? 484
    Cultural Awareness 486
    Cultural Knowledge 487
    Cultural Sensitivity 487
    Cultural Competence 487
    Conclusion 488
    Chapter Summary 489
    References 489
    47 Peer Learning to Develop Clinical Reasoning Abilities 491
    Chapter Aims 491
    Key Words 491
    Abbreviations/Acronyms 491
    Introduction 491
    Peer Learning for Knowledge and Metaskills Development 491
    Peer Learning Activity Design Considerations 492
    Peer Assessment 492
    Facilitating Clinical Reasoning Development With Peer Learning 493
    Examples of Peer Learning Activities for Clinical Reasoning Development 494
    Peer Learning With Simulation 494
    Peer Learning in Interprofessional Clinical Settings 495
    Conclusion 496
    Chapter Summary 496
    References 496
    Index 499
    A 499
    B 499
    C 499
    D 502
    E 503
    F 504
    G 504
    H 504
    I 505
    J 506
    K 506
    L 506
    M 506
    N 507
    O 507
    P 508
    Q 509
    R 509
    S 510
    T 511
    U 511
    V 511
    W 511
    X 511

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