In this video, we aim to delineate the concepts of clinical reasoning and critical thinking, and how they are related, but not exactly the same. All therapists use clinical reasoning in order to make clinical decisions. However, much of our reasoning left to itself is uninformed, distorted, partial, biased, or downright lazy. Yet the quality of our clinical practice depends precisely on how we think about it. on the quality of our clinical reasoning.
Inferior clinical reasoning is costly both in money and quality of life. Excellence in clinical reasoning should be systematically cultivated, but first we have to have an understanding of what is involved in excellent clinical reasoning. In order to ensure clinical reasoning skills are informed, comprehensive, and unbiased, we have to examine our thinking and reasoning.
Critical thinking is that mode of thinking about any subject, content, or problem in which one improves the quality of his or her thinking by skillfully taking charge of the structures inherent in thinking and imposing intellectual standards upon them. Through consistently applying the rigors of critical thinking to our clinical reasoning process, our clinical reasoning will improve over time and so will our practice. When we apply the traits and habits of critical thinking to our clinical reasoning, we ensure biases are examined, the breadth and depth of our thinking are complete, we are humble in examining our thinking, and we admit what we know and what we don't know. Examples of well-cultivated critical thinking applied to clinical reasoning include asking the right questions and identifying relevant problems, inclusive of factors that the patient brings to the encounter, such as culture, history, and psychosocial factors.
Gathering and assessing relevant information through choosing and skillfully performing appropriate tests and measures and expertly analyzing movement. Considering and applying appropriate abstract ideas, theories, and analysis to the data. and perspectives such as movement frameworks, Bayesian inference, or concepts of behavioral psychology to interpret data effectively and derive to well-reasoned conclusions and solutions, testing them against relevant criteria and standards. Thinking open-mindedly and collaboratively with patients, caregivers, and other practitioners considering alternative systems of thought, recognizing and assessing their assumptions, implications, and practical consequences in intended outcomes.
communicating effectively with the patient and others to arrive at solutions to complex, multifaceted problems. The iterative nature of reasoning causes us to constantly evolve and change our thinking as we gain experience, while always applying the standards of critical thinking as our reasoning changes and adapts, reflecting on our reasoning while applying the standards of critical thinking. critical thinking is known as metacognition. Metacognition brings awareness and understanding of one's own thought processes related to clinical reasoning.
Critical thinking and clinical reasoning are inherently related, but using the term critical thinking to describe clinical reasoning in physical therapy leaves out the unique perspectives of physical therapy, such as patient-centered care, movement analysis, and the biopsychosocial model. Based on this, it is important to be mindful to use the term clinical reasoning when we are talking about the thinking and reasoning related to patient-client management. To learn more about clinical reasoning, visit the website for the Clinical Reasoning and Curricula Assessment Consortium of the American Academy of Medicine.
American Council of Academic Physical Therapy.