Identification of the Essential Elements in the Clinical Reasoning Process in Health Care Professionals
Gonzales, Pam Joplin
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Clinical reasoning is an essential skill all health care professionals must learn and continue to develop. Clinical reasoning combines thinking strategies to reason about a patient’s real or potential problem (Delany & Golding, 2014). Health care professionals with poor clinical reasoning skills are prone to miss subtle patient changes thereby failing to prevent patient deterioration (Levitt-Jones et al., 2010). Given that hospitalized patients are more ill than in years past, it is imperative that educators ensure health care professional students graduate with a beginning level of clinical reasoning congruent with safe practice and practicing professionals continue to develop this skill. Patients’ conditions can change rapidly often with fatal consequences and health care professionals must be able to interpret these changes and react quickly (Benner, 2010). Despite the current literature on clinical reasoning, the essential elements of the clinical reasoning process have not been identified. The research design used was a Delphi study with a survey that consisted of the potential essential elements and clinical reasoning phases based on a literature review. Content experts from the professions of nursing, medicine, physical therapy and occupational therapy came to consensus on the essential elements of the clinical reasoning process used by health care professionals. In a two round Delphi study via Survey Monkey(R) the experts identified a final total of 59 essential elements in the clinical reasoning process spread across five phases of clinical reasoning.