What Is Clinical Reasoning?

Welcome to another episode of The Words Matter Podcast. 

So we continue on the clinical reasoning series, and on this episode I’m speaking with Mark Jones. And if you haven’t already listened to the previous episode in the series “Do clinicians think link scientists” with Roger Kerry, I suggest you take a listen as my conversation with Mark builds nicely from there.

Mark is an Adjunct Senior Lecturer in the University of South Australia with 35 years’ experience teaching undergraduate and postgraduate physiotherapy.

He has a special interest in biopsychosocial health care and the teaching and assessment of clinical reasoning in physiotherapy. Mark has conducted and supervised research in the areas of clinical reasoning and musculoskeletal physiotherapy with over 90 publications including three editions of the text “Clinical Reasoning in the Health Professions” and the text “Clinical Reasoning for Manual Therapists”. His latest text “Clinical Reasoning in Musculoskeletal Practice” was published in 2019.

And he has been on one of the major contributors to the development of clinical reasoning theory within MSK healthcare in the last 30 years, and we discuss some of his key work, including the seminal work with the late Louis Gifford and Ian Edwards (see Ian's work on clinical reasoning here here and here).

So on this episode we talk about: 

• The development of clinical reasoning theory beyond mere diagnostic reasoning.
• Different aspects or strategies of clinical reasoning such as procedural, predictive and collaborative reasoning.
• The pursuit of a structural or pathological diagnosis.
• Mark's own clinical reasoning framework involving hypothesis categories.
• Clinical reasoning within a biopsychosocial framework.
• Diagnostic reasoning approaches such as hypothetico-deductive reasoning and pattern recognition.
• Clinical reasoning in novice compared to expert clinicians.
• And finally we discuss the role of metacognition to mitigating errors in reasoning.

So it was truly and honour speaking with Mark. The label ‘pioneer’ is probably over used, but in Mark’s case it captures his status perfectly. His work on clinical reasoning theory was one of the cornerstones of my own doctoral work into clinical reasoning (see here here and here) and helped make explicit the processes behind my thinking and doing in my clinical practice – which up until engaging with Mark’s work were completely unbeknownst to me.

His knowledge of the field is incredibly extensive as is his ability to communicate and make this information accessible to clinicians and students.

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