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Higgs and Jones(2000) outline the following approaches to Clinical Reasoning.

  1. Hypothetico-deductive reasoning – The clinician formulates a hypothesis after observing their patient/client and combines this with their existing knowledge. Than they aim to confirm diagnosis with further tests.

  2. Pattern Recognition - The clinician relies on knowledge and experience of common presentations which they recognise in a new patient/client.

  3. Knowledge reasoning integration - The integration of a clinicians knowledge/cognitive skills with reasoning

  4. Interpretive reasoning styles:
      • Diagnostic reasoning -  Aims to reveal the patients/clients impairments
      • Interactive reasoning – Developed from patients/clients interactions
      • Narrative reasoning – Reasoning based on stories which give us an understanding of the patient/clients motivations and actions.
      • Collaborative reasoning – Shared decision making
      • Predictive or conditional reasoning – Predicting what will occur based on information collected
      • Ethical reasoning – Reasoning based on our ethical thinking
      • Teaching as reasoning - Conscious use of advice, guidance and instruction to change patients' understandings, feelings and behaviours

It is generally recognised that most professionals will use a variety of approaches based on their individual circumstances.

Reflection Activity

How do you reason?

Do you have a particular style/favored method?

Do you change according to the circumstance?

Consider for each approach, if your student used that approach in your setting, would it pose any particular challenge? If a student demonstrated this approach, would you attempt to modify their approach? If so, why and how would you do it?


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