Clinically Useful Clinical Reasoning

Course Description:

This course addresses four areas of higher order thinking:

(1) Balancing System I and System II Thinking Processes;

(2) Targeting care that actually matters to health outcomes;

(3) Navigating the unexplained and unknown; and

(4) Recognizing the consequences of what you do (and what you don’t do). These areas are designed to improve decision making for individuals who are new to seasoned clinicians; not early learners.

Course Objectives: 

- Understand the definition of higher order thinking
- Recognize the balance between system 1 and system 2 learning
- Compare and contrast interventions that influence outcomes the most
- Recognize that ambiguity is normal in rehabilitation management
- Analyze the concepts of medicalization and overdiagnosis.

Course References:

1.    Berner et al. Overconfidence as a cause of diagnostic error in medicine. Am J Med. 2008;121:2-23
2.    Claxton LD (2005) Scientific authorship Part 1. A window into scientific fraud? Mutation Research-Reviews in Mutation Research 589: 17–30.
3.    Cook CE, Décary S. Higher order thinking about differential diagnosis. Braz J Phys Ther. 2019 Jan 30. pii: S1413-3555(18)31066-9. doi: 10.1016/j.bjpt.2019.01.010. [Epub ahead of print] Review.
4.    Cook CE, George SZ, Reiman MP. Red flag screening for low back pain: nothing to see here, move along: a narrative review. Br J Sports Med. 2018 Apr;52(8):493-496.
5.    Klein J. Five pitfalls in decisions about diagnosis and prescribing. BMJ 2005;330:781-783.
6.    Marcum JA. An integrated model of clinical reasoning: dual-process theory of cognition and metacognition. J Eval Clin Pract. 2012 Oct;18(5):954-61.
7.    McGinnis JM, Williams-Russo P, Knickman JR. The case for more active policy attention to health promotion. Health Aff (Millwood). 2002;21(2):78-93.
8.    Norman G, Monteiro S, Sherbino J Is clinical cognition binary or continuous? Acad Med. 2013 Aug;88(8):1058-60. 
9.    Pinnock and Welch. Learning clinical reasoning. J Paediatrics and Child Health. 2014;50:253-7. Soc Sci Med. 2017 Jun;183:28-36. doi: 10.1016/j.socscimed.2017.04.025. Epub 2017 Apr 15.
10.    Strauss S, Stavy R. U-shaped behavioral growth: Implications for theories of development. In W. W. Hartup (Ed.), Review of child development research (vol. 6) (pp. 547-599). Chicago: University of Chicago Press. 1982
11.    Bröer C, Besseling B. Sadness or depression: Making sense of low mood and the medicalization of everyday life. Soc Sci Med. 2017 Jun;183:28-36. doi: 10.1016/j.socscimed.2017.04.025. Epub 2017 Apr 15.