Health care professionals around the world who
work in the medical field need to have many skills to decide how to deal with
or manage a patient’s case. There are many skills that the therapists need to
have, and the clinical reasoning is one of them. This essay will define
clinical reasoning, its main models, and compare them to each other.


 “Clinical Reasoning is the process by
which a therapist interacts with a patient, collecting information, generating
and testing hypotheses, and determining optimal diagnosis and treatment based
on the information obtained.”1 Clinical reasoning is very
important for therapists because they have to make quick and critical decisions
when they face a patient’s problems. At the beginning of their residency
doctors may do wrong decisions and may do errors. “Clinical reasoning
should begin as soon as the therapist meets the patient as their behavior can
inform the therapists clinical reasoning.”1 “There should be ongoing data collection which should not stop at the end
of the assessment to aid this process.” 1

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To make a good
decision there are many models for the process of clinical reasoning. 3
The first model is knowledge- reasoning integration. 3 It is the
incorporation of mutual decision making process with the patient. 3
It occurs in stages, and it also involves three main elements (knowledge,
cognition, metacognition). The first element is knowledge, normally people
acquire their knowledge from schools, and also, they might acquire it from the life.
3 The second one is cognition, which is the mental action or process
of acquiring knowledge and understanding through thought, experience, and the
senses. 2,3 And the third element is metacognition, which is the
awareness or the understanding of the therapist’s own thought process. 2
The second model is the integrated patient-centered model. 3 In
this model at the initial encounter with patients, the therapist will ask them
and talk with them to have a critical clinical reasoning. 3 As the
first model has elements this model has also many elements that have to be
considered of. 2 (Cognition, metacognition, the clinical problem,
knowledge, the environment, and the client’s input) these are the elements of
the integrated patient-centered model. 2,3 After taking care of
the elements the understanding of the patient and the clinical problem will
grow effectively to help the therapist to find the perfect treatment plan. 2,3
Hypothetico-deductive reasoning is the last model that will be discussed about.
3 It is the process of generating a limited number of hypotheses
early in the encounter and using them to guide the subsequent data collection. 3
“What this model adds to the previous knowledge was that in contrast to the
traditional understanding that recommended we should first gather extensive
information of the patients through a complete history and physical exam, and
generate a list of differential diagnoses (13), hypothesis generation is an
early event in the diagnostic reasoning process.” 3 

To sum up,
clinical reasoning is a very important skill that every therapist should have,
to help them make the perfect decisions to help their patient in progressing
their treatment plan. And sometime clinical reasoning might not be that much
able to be thought in schools more than it could be acquired from practicing it
in the medical life.










1.     1 Physiopedia. Clinical reasoning. 2017cited December 16,


available from:




2.     2 School of Nursing and Midwifery Faculty of
Health, University of Newcastle.
Clinical reasoning. 2009cited December 16, 2017

available from:


3.     3 NCBI. Models of clinical reasoning.2017cited December 16,

available from:



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