![]() Since GPs’ goals are often different from those of specialties (where a definitive diagnosis is the typical goal), the end point of clinical reasoning process may be different. Since the GPs encounter the disease in its early stages, diagnosis has to be made with higher level of uncertainty compared with more differentiated presentation of later stages of diseases observed in hospital practice ( 8). ![]() Since the probability of diseases seen in general practice is different from that in selected patients referred to specialties, the initial diagnostic hypothesis will be different in other words, at least the list at differential ranking order is not similar. ![]() The GPs have to be particularly responsive to behavioral clues. Since many patients are visited at the early stages of disease progression, the cues to decide on are fewer and sometimes different. General practice has many features which differentiate it from specialty care setting. In most of these studies, the main focus was to study the difference between novices and experts in terms of clinical reasoning skills ( 7), and little attention has been paid to clinical reasoning in general practice. However, when it comes to action, to plan relevant learning experiences and assess the level of achievement by the medical students, we see that the whole story grows more complicated ( 7).ĭuring the last four decades, studies on the nature of clinical reasoning have advanced our knowledge on the subject and different models have been developed for describing the factors contributing to clinical reasoning. All agree that clinical reasoning or one of its equivalent terms, such as problem solving diagnostic reasoning and clinical judgement, should be taught and examined. In fact, medical educators believe that clinical reasoning is a central component of physicians’ competence and during the last 3 decades, an increasing number of medical education bodies and medical schools recognize this competence in their recommendations and documentations. Over 70% of all diagnoses in general practiceĪre based on history taking ( 5) and diagnostics is estimated to be the largest part of all GPs' work (80%-85%) ( 6).Īs diagnosis is a central component of the physicians' tasks, the teaching and learning of diagnostic reasoning should have a critical position for medical education system. ![]() They select symptomsĪnd put them together with what they find as they observe the patient, take history and do physical examinations ( 4). For every patient, GPs try to translate the patients' narration of their problem into a possible diagnosis. Of complaints and concerns, with often minor but sometimes serious symptoms. Every day general practitioners (GPs) visit patients with a wide variety Diagnosis lies at the heart of general practice ( 1- 3). ![]()
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