Clinical Reasoning | Assignment Help
Question 1: In a couple of sentences outline why it is difficult to distinguish between clinical-decision making errors solely due to intuitive judgment or analytical judgment.
The clinical decision-making is the most crucial process in the whole process of providing complete and proper health care. During the clinical decision making, the paramedics resort to either intuitive judgment or analytical judgment. Though both these methods have their own advantages, they have proved to be faulty in numerous cases. The errors in both types of judgments can prove to extremely critical for the health of the patient (Berner ES et al, 2008). It is difficult to distinguish between the errors produced by intuitive of analytical judgment. This is so because both the procedures are inter-linked and inter-woven. When a paramedic applied intuitive judgment in case of emergency, he/she is automatically acting out of all the experience and knowledge he/she has gained from their studies and previous cases. Thus, even without thinking, intuitive judgment involves some amount analytical thinking.
Similarly, when a paramedic uses analytical judgment for deciding what procedure to follow in a particular case of emergency, he/she comes up with many plausible routes and diagnosis. Now, intuitive thinking is required to choose one of them (Federspil G et al, 2001). Hence, booth the methods are inter-linked and can result in errors which can be very difficult to distinguish and analyze.
Question 2: Current literature points to a debate surrounding the reliability of intuitive clinical reasoning in comparison to the analytical, hypothetico-deductive, process of reasoning. Discuss and debate current findings. (4 marks) (400 words)
It has been reported in current literature that intuitive reasoning leads to several errors in the clinical decision making process. Intuitive clinical reasoning cycle works on the basis of the knowledge pattern recognition in order to diagnose the medical condition of the patient. According to the researches, this pattern recognition can many a times lead to wrong interpretation of the aliment because many severe medical conditions might have similar symptoms during an emergency situation (Croskerry P et al, 2002). Thus, according to the reports, intuitive reasoning is not as effective as analytical, hypothetico-deductive methods of reasoning.
But, in my opinion focusing only on the analytical and other cognitive decision making approach is the methodology of a novice. Most of the experienced doctors and paramedics rely not solely on analytical judgment but also infuse a huge amount of intuitive judgment while diagnosing a patient and deciding on the type of treatment. Intuition is all about knowing what are unconscious knows. The voice of the unconscious is not some random opinion, but it is an instinctive recognition of symptoms which formed over years of practice. Pattern recognition is not a technique which can be developed overnight instead it is the deep knowledge and understanding of clinical symptoms which is gathered over years of experience and observation (Cote L et al, 2005).
When a paramedic relies solely on analytical and other methods of cognitive thinking then the symptoms might not fully disclose the actual ailment and lead to paramedics providing incomplete health care. To be able to provide complete healthcare the in-depth understanding of the symptoms is required. To gain this in-depth understanding one requires to refer to past experiences of similar nature in order to understand what went right or what went wrong in those cases. The intuition about what the patient exactly needs in the situation of clinical emergency is not random haunch about knowing things; instead it is the combined knowledge of ethics and past-experience which guides the paramedics towards delivering the right treatment (Federspil G et al, 2001).
Thus, it can be safely said applying cognitive or analytical reasoning alone has higher chances of producing errors when compared to infusing it with pattern recognition and intuitive thinking. Intuitive decision making while in health care is extremely essential to make the right decision at the right time (Dijksterhuis A, 2004). Conclusively, one cannot completely demerit the reliability of the intuitive decision making process because it is one of the most powerful tools of the clinical thinking process. It opens the gates of experience and knowledge which the analytical methods lack.
Question 3-: Why is clinical reasoning a ‘bounded’ process? Discuss.
Clinical reasoning is defined as bounded process because it has many constraints, restrictions and boundaries. The constraints in the clinical reasoning process include the limited amount of time in the case of emergency to take a decision, the limited information in the form of symptoms, and the limited capacity of human mind to asses and analyze the situation (Berner ES et al, 2008). Under all these boundaries, the clinical decision making becomes a bounded process.
- Limited Information-: The first restriction that a paramedic is forced to face while taking any clinical decision is the limited information available at hand. In case of an emergency, when the patient needs immediate help and is not in the condition to talk, the paramedic has no time to waste (Croskerry P, 2002). Thus, he/she cannot check the previous medical history of the patient to understand the current symptoms neither can he ask the patient. Now, the paramedic has to make a good, ethical and logical decision about providing treatment to the patient only on the basis of the condition of the patient. This can lead to wrong diagnosis and permanent damage to the patient.
- Limited Capacity of Human Mind-: This is another restriction on the clinical decision making process. The paramedic as experienced or sharp he might be is faced with the limitation of human mind to asses and analyze the amount of information available at once. To understand all the symptoms and analyze them to take a proper, coherent and cognitive decision is very tough (Federspil G et al, 2001).
