The role of clinician emotion in clinical reasoning: Balancing the analytical process

Abstract

TitleThe role of clinician emotion in clinical reasoning: balancing the analytical process.Key words: Physiotherapy; reasoning; emotion. Authors DiscussionIt is proposed that clinicians should consider the emotions associated with decision-making, especially when there is concern surrounding a presentation. Reflecting on practice in the clinical environment and subsequently applying this to a patient presentation should involve some acknowledgement of clinicians' physical responses, emotions and how they may play a part in any decision made. Presenting intuition and gut-feeling as separate reasoning methods and how these processes co-exist with other more accepted reasoning such as hypotheticodeductive is also discussed. ConclusionMusculoskeletal physiotherapy should consider the elements of feelings, emotions and physical responses when applying reflective practice principles. Furthermore, clinicians dealing with difficult and challenging presentations should look at the emotional as well as the analytical experience when justifying decisions and learning from practice.

Developing a framework for teaching clinical reasoning skills to undergraduate physiotherapy students: A Delphi study

“…Pattern recognition and professional intuition are most likely "fast" thinking processes. Professional or clinical intuition has been described as a "feeling" and may also overlap with "clinical gut feeling" (Langridge, Roberts, & Pope, 2016;Peters et al, 2017;Van den Bruel, Thompson, Buntinx, & Mant, 2012). Hypothetico-deductive reasoning is a "slow" thinking processes, being analytical, conscious and conceptual (Peters et al, 2017).…”

“…At undergraduate levels, it is more likely that the "slow" thinking processes develop first, based on progressively acquired knowledge. Increasing reliance on pattern recognition and professional intuition has been described as being directly Notes: PhD, Doctor of Philosophy; *Participants were classified as "general" if they indicated that or indicated two or more of the above fields as being their clinical practice areas associated with increased clinical exposure (Langridge, Roberts, & Pope, 2015;Langridge et al, 2016). Use of the "fast thinking" processes, particularly clinical intuition, may thus be expected to be increasingly important during the final year of study or when practising as a graduate physiotherapist.…”

“…Such factors include their level of expertise, clinical education and experience as well as their beliefs regarding clinical practice, education and pedagogy, and their interpretation of the evidence in addition to their personal, cultural and ethical values and communication skills (Langridge et al, 2015;Patton et al, 2018). Self-awareness is thus required both by students and by educators to fully achieve the necessary critical analysis, communication and clinical skills (Langridge et al, 2016). Educators need to remain flexible and familiar with the wide range of elements influencing clinical reasoning.…”

Musculoskeletal ultrasound imaging - An exploration of physiotherapists' interests and use in practice

“…Several authors have explored tacit knowledge in relation to learning and health care professionals and generally use the term to describe knowledge that is rarely fully articulated, there is however a lack of consensus regarding whether tacit knowledge can be communicated or only represented, (Eraut 2000, Reinders 2010. Researching the presence of tacit knowledge and the non-formal learning that is associated with it presents many challenges and the literature exploring this domain is expanding (Eraut 2005, Carrier et al 2010, Langridge et al 2016. Authors propose tacit knowledge underpins the clinical decision making that punctuates professionals' practice during tasks and it could be debated to be a more accurate term than the One participant's comments reflects the widely reported opinion that a normal scan is not a waste of time and can be a therapeutic intervention:…”

Pain Viewed from the Outside: A Response to Verpaelst

“…This can lead to misjudgement regarding what is reported or expressed by someone experiencing pain. Our perceptions and emotions can also influence our interventions [9] and clinical reasoning [10].…”