Clinical Reasoning Toolkit
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The clinical reasoning literature has advanced in concert with the rapid growth of cognitive psychology, the discipline which examines how the mind learns, reasons, and makes judgments. A basic understanding of how the mind works is critical for analyzing our diagnostic and management decisions.

Quick Take: read the iBook "The Science of the Art of Medicine” by John Brush. You can read a review of the book Here.

Core resources (additional high-yield introductory information) are indicated by a STAR icon.


General references View

The Science of the Art of Medicine by John Brush [iBook available at iTunes]

A brief and highly accessible overview of the cognitive and quantitative topics that govern physician decision making.

Thinking, Fast and Slow by Daniel Kahneman

A comprehensive but accessible overview of System 1 (intuitive) and System 2 (analytical) reasoning and decision making.

Learning Clinical Reasoning by Jerome Kassirer, John Wong, Richard Kopelman

A thorough introduction to clinical reasoning followed by many illustrative case studies.

Norman G. Research in clinical reasoning: past history and current trends. Medical Education. 2005.

Overview of the history of clinical reasoning and the evolution of the different concepts of expert reasoning, from the 1980’s onwards.

Geoff Norman "Clinical Reasoning"

A 49 minute video on the evolution of clinical reasoning concepts and research paradigms.

Dual Process Model of Reasoning View

Croskerry P. A universal model of diagnostic reasoning. Academic Medicine. 2009.

Detailed theoretical discussion of the Dual Process Model (System 1 and System 2 reasoning)

Dual Process 2 slides

Two slide overview of the Dual Process Model (System 1 and System 2 reasoning).

Cognitive and Linguistic Sciences Brown Univ CG 195 Shotola

This presentation illustrates how heuristics (mental shortcuts) can lead to either systematic judgment errors (biases) or intelligent decisions.

Dual Process Theory Complete Bibliography

Naturalistic Decision Making View

Kahneman D, Klein G. Conditions for intuitive expertise: a failure to disagree. The American Psychologist. 2009.

An engaging compare and contrast of the heuristics and biases viewpoint and the NDM viewpoint of human decision making with a discussion of the conditions that separate true intuitive skill from overconfident and biased impressions.

Sources of Power: How People Make Decisions by Gary Klein

An examination of real-world expert decision making which emphasizes experience and the use of environmental clues to trigger/adapt/improvise solutions in work environments.

Schleifer JW, Centor RM, Heudebert GR, Estrada CA, Morris JL. NSTEMI or Not: A 59-Year-Old Man with Chest Pain and Troponin Elevation. Journal of General Internal Medicine. 2012.

A chest pain case analysis that highlights NDM’s recognition-primed decision making approach.

Naturalistic Decision Making Bibliography

Mental Sub-processes Model View

Bowen JL. Educational strategies to promote clinical diagnostic reasoning. New England Journal of Medicine. 2006.

A concise introduction to problem representation, illness scripts, and the compare and contrast strategy that characterizes clinical decision making.

Catherine Lucey "Clinical Problem Solving" (Coursera)

A six session on-line course that provides a comprehensive overview of clinical reasoning principles with practical examples, case-studies, and on-line forum. (Currently not offered but will be re-activated in near future).

Catherine Lucey "From Problem Lists to Illness Scripts"

A summary of many of the concepts in the Coursera Course.