In the daily life of a nurse, clinician or a doctor, Clinical Reasoning Cycle is a very important aspect as it can be a matter of life and death for a patient. It is an integral part of the diagnosis process. It is a step by step process through which a nurse judges and analyses the treatment process and makes required amends.
Among all other pre-requisites that a nurse is required to have, like ability to work long hours, handling a wide range of responsibilities, and unpredictable schedules; critical thinking and reasoning skills are of the utmost importance in the nursing career.
Clinical reasoning cycle can be defined as the critical thought process of a nurse or a health professional through which they collect information through cues, reports and tests and analyse this information to devise a treatment plan for the patient.
Since every human body responds to stimulus in its own way, thus it is very important for a nurse or a doctor to consider every aspect and every possibility while treating a patient as even the smallest miscalculation can have dire consequences on the life of an individual.
Clinical reasoning is often confused with terms like clinical judgement, critical thinking, clinical decision making and problem solving when in truth is an amalgamation of all of these.
Clinical reasoning employs all of these capabilities in its process that is why it is known as a cycle. Clinical reasoning is not a linear method but in fact it is a spiral of studies and encounters (Levett-Jones, 2013).
Importance of Clinical Reasoning Cycle
In most of the survey reports, questioning the reason of unsatisfactory healthcare or treatment, the result was found to be incorrect diagnosis. In a lot of cases this has led to permanent disability, excruciating pain and even death in some cases.
As the ultimate goal of any health professional is to save lives and provide the best treatment, it is very important to evaluate the information and clues correctly for a successful diagnosis.
Clinical Reasoning Cycle is sometimes termed as on the founding pillars on which the medical community stands, because it enables the caregiver to not only devise a suitable plan of treatment but it also helps them to predict the results and outcome of the treatment to a significant extent.
Therefore, medical and nursing students try to develop an instinct of clinical reasoning skills to improve the quality of care. In fact it is an integral part of the United States Medical Licensing Examination commonly known as USMLE.
Therefore it is necessary for medical aspirants to demonstrate a certain level of clinical reasoning skill to get their license to practice medicine, as a doctor or registered nurse.
Since medical research is an ever evolving subject, most of the Doctors and medical professionals continuously look towards enhancing their cognitive clinical reasoning skills.
In order to achieve this, they regularly read medical journals and case studies to be up to date about the new diseases, treatments and medicines and their implementation.
Phases of Clinical Reasoning Cycle
Clinical Reasoning is an 8 phased process. Although it follows a flow of steps it should be noted that due its grave importance, it not a linear progression.
While doing the analysis the nurses or doctors frequently go back to previous steps in light of new evidence or to make necessary corrections. Therefore, clinical reasoning is a cyclic and continuous process of critical thinking.
The 8 phases of Clinical Reasoning Cycle are as follows:
- Gathering Information
- Identification of problems
- Establishing Goals
- Evaluation of Outcomes
Let us explain each of these steps in brief.
This is the first step, where you are introduced to the particular case. Here the nurse or doctor familiarises themselves with the current status of the patient and the previous treatments already done.
This phase plays an important role in determining the further steps to be taken. Here the nurse gathers all the relevant information about the patient like medical history, allergies, genetic issues, present condition, and considerations of test reports.
After collecting all the necessary information, it is now time to analyse those clues and symptoms in order to devise the multiple ways in which a certain symptom can be treated. In this part, utmost care is to taken considering all the possibilities and outcomes of the proposed plan.
Identification of problems
In this step, after carefully analysing all the factors and health conditions, the problems and issues are pointed out and classified in the order of their priority. The various causes and inferences are made which facilitates the selection of treatment.
Based on the issues identified, goals are set in order to eliminated and efficiently treat the symptoms. These goals determine the treatment which will take action for the betterment of the patient.
Now the proposed treatment is set into action. The patient undergoes treatment and their progress is observed. At this step, all the individuals who will be interacting with the patient have to be on the same page so as to maintain effectiveness.
Evaluation of Outcomes
After considering the progress and other results, the evaluation of these outcomes determines further steps in the decision making process, if the treatment is found to be successful then it is carried on till the completion of the course, else the process goes back to the analysis phase the situation is analysed again and another plan is put forth.
This is the final phase of reflection, which is carried out after the completion of the treatment. In this segment the whole process is analysed and the findings are looked at carefully in order to determine the learning outcomes of the case which can be of importance in future treatments.
How to improve Clinical Reasoning Skills
Clinical reason is not a topic which you may read once and learn it, in-fact it is an important skill which has to be developed over time with experiences and knowledge.
Many reports and studies has found that new nurses who have just got their licenses are mostly incompetent , as they do not have the required and necessary critical reasoning skill which they would have to apply on a day to day basis.
Clinical reasoning has two approaches; approach 1 is quick and instinctive whereas approach 2 is slow and detailed.
In approach 1 the critical thinking is fast and comes instinctively as soon as you gather all the necessary requirements. It is generally applied by doctors and nurses when they confront a familiar case.
Approach 2 is slow and analytical, it is usually performed when a new case or disease is confronted, and therefore requires detailed analysis of the problem.
In the beginning of their careers, health professionals tend to use the second approach, but as their knowledge and experience grows they develop an instinct to analyse a situation quickly and make the right decisions.
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