Learning Clinical Reasoning

ISBN-10: 078179515X
ISBN-13: 9780781795159
Edition: 2nd 2010 (Revised)
List price: $65.50
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Description: Clinical reasoning is the analysis process which assists practitioners when making decisions associated with the evaluation and treatment of a patient. One of the hardest and most intimidating skills for students to learn is how to confidently make  More...

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Book details

List price: $65.50
Edition: 2nd
Copyright year: 2010
Publisher: Lippincott Williams & Wilkins
Publication date: 9/11/2009
Binding: Paperback
Pages: 352
Size: 7.00" wide x 10.00" long x 0.75" tall
Weight: 1.188
Language: English

Clinical reasoning is the analysis process which assists practitioners when making decisions associated with the evaluation and treatment of a patient. One of the hardest and most intimidating skills for students to learn is how to confidently make a clinical decision on their own. Much of this comes with practice and experience, but there are useful skills students need to master in order to effectively come to a diagnosis. Learning Clinical Reasoning outlines the basics of clinical reasoning; the steps in the clinical process, inductive and deductive strategies, data collection and its flaws, and assessing the reliability of clinical evidence.

Foreword
Preface to the Second Edition
Acknowledgments
A Note About the Book's Format
The Processes of Clinical Reasoning
Overview
Introduction
Diagnosis is an Inferential Process
Problem-Solving Strategies
Diagnosis Based on Hypothesis Generation and Testing
Alternate Concepts of Diagnostic Strategies
Therapeutic Principles
Linking Diagnosis and Treatment
Diagnostic Hypothesis Generation
Hypotheses and Cues
The Cognitive Basis of Hypothesis Generation
Hypotheses as a Context
Expertise and Error
Refinement of Diagnostic Hypotheses
Where Refinement Begins and Ends
Context and Diagnostic Classification
Hypothesis Evolution
Sequence of Data Collection
Reducing Diagnostic Uncertainty
The Differential Diagnosis
Relation to Formal Probabilistic Approach
Use and Interpretation of Diagnostic Tests
The Function of Tests
Quantifying Testing Decisions
Sensitivity and Specificity
Bayes' Rule
Testing Principles
Bayesian Revision for Multiple Results
Bayesian Revision for Multiple Diseases With Multiple Attributes
Pragmatic Considerations in the Probabilistic Approach
Interpreting Results
When to Test
The Threshold Concept
The Therapeutic Threshold
Testing Thresholds
Causal Reasoning
Definition
Using a Causal Model
Where in the Diagnostic Process Does Causal Reasoning Fit?
Explaining Relations Between Variables
Diagnostic Verification
Definition
Criteria of Validity
Premature Closure
The Penultimate Result: A Working Diagnosis
Therapeutic Decision Making
Principles
Treatment Under Conditions of Uncertainty
When the Value of Therapeutic Choices is Close
Incommensurate Options
Quantitative Therapeutic Decision Making
Examining Evidence
Introduction
Evidence-Based Medicine
Asking Questions
Searching for Evidence
Summarizing and Appraising Evidence
Applying the Evidence
Practice Guidelines
Cognitive Errors
Scope
Classification
Some Errors may have a Psychological Origin
The Nature of Cognitive Errors
Cognitive Biases in the Laboratory
Consequences of Cognitive Biases
Strategies for Avoiding Cognitive Errors
Some Cognitive Concepts
Cognitive Science
Studying Mental Processes
The Structure of Memory
Search Strategies
Characteristics of Expertise
Learning Clinical Problem Solving
Facts Versus Process
Pedagogic Principles
A Specific Example
The Goal Should Determine the Format
Learning by Instantiation
Learning Clinical Problem Solving Versus Problem-Based Learning
Cognition at the Bedside: A Set of Examples
Introduction to the Cases
Diagnostic Hypothesis Generation
Generation of Diagnostic Hypotheses
Hypothesis Triggering by an Expert
A Diagnostic Coup
A Quick and Accurate Solution
Better Late Than Never
A Hit After a Miss
The Critical Role of Context in the Diagnostic Process
A Masked Marauder
A Serious Lack of Focus
Refinement of Diagnostic Hypotheses
What is a Differential Diagnosis?
An Orderly, Sequential Approach
Weak Reasoning: Diagnosis by Drug Reaction
Narrowing Down the Diagnostic Options
A Picture is Worth a Thousand Words
Strategies of Information Gathering
A Fatal Flaw in Sutton's Law
How to Disregard Red Herrings
Discrimination: The Problem of Look-Alikes
Location, Location, Location
Use and Interpretation of Diagnostic Tests
Interpreting a Negative Test Result
Diagnosis and the Risks of the Primrose Path
Searching for a Pony
Interpreting Hoofbeats: Can Bayes Help Clear the Haze?
Short-Circuiting the Diagnostic Process
The Bypass on the Way to the Bypass
It is What You Believe That Counts
Renal Rescue by Reverend Bayes
A Diagnostic Fluke
Surprise!
Tripping Over Technology
The Probability of a Probability
Causal Reasoning
Judging Causality
Post Hoc, Ergo Propter Hoc
The Case for Causal Reasoning
The Tricky Task of Attributing Causation
The Right Answer for the Wrong Reason
Diagnostic Verification
A Point-By-Point Dissection of Clinical Reasoning
Leaving No Stone Unturned
Verification
A Meticulous Approach
A Diagnostic Quandary
Diagnosis by Fiat
Iron Pyrite and Diagnostic Confirmation
Therapeutic Decision Making
The Surgeon Opts to Operate: Why?
Treat or Keep Testing?
Watch and Wait, or Operate?
An Apple or an Orange?
Examining Evidence
A Difficult Tradeoff
Making Judgments When the Evidence is Not Definitive
Using and Citing Published Evidence
A Little Math Makes the Medicine Go Down
A Rewarding Pursuit of Certainty
Treating Before Knowing
Cognitive Errors
A Defective Detective
Remedies for Faulty Hypothesis Generation
A Disaster Averted
Derailed by the Availability Heuristic
Wrong Diagnosis, Wrong Tests, Wrong Treatment
Reconsidering Failures of Therapy
The Cheetah and the Snail
A Collection of Cognitive Diagnostic Errors
Some Cognitive Concepts
A Message about Methods
Memory: How We Overcome its Limitations
Diagnosis and the Structure of Memory; Disease Polymorphism and Mental Models
Intuitive and Inspirational, or Inductive and Incremental?
Knowledge and Clinical Expertise
Learning Clinical Problem Solving
Learning Clinical Reasoning from Examples
Making a Silk Purse out of a Sow's Ear
Optimizing Case Discussions
Glossary
Bibliography
Index

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