If you’re a medical or nursing student, you may have frequently heard of the term “clinical reasoning.” So what does this term mean? Clinical reasoning refers to all the cognitive processes employed by nurses, clinicians, and other health professionals in analyzing a clinical case or a patient’s condition, reaching an accurate diagnosis, and proffering the appropriate treatment plan.

Clinical reasoning thus involves the integration of all the acquired knowledge, balancing evidence, and drawing from experience to reach a definitive diagnosis of a patient’s condition. In other words, all the thought processes a clinician uses, for example, to correctly diagnose a perforated peptic ulcer in a patient with severe abdominal tenderness, is called clinical reasoning.

Clinical reasoning has sometimes been used interchangeably with phrases such as clinical judgment, critical thinking, decision making, and problem-solving.

Why is clinical reasoning important?

Clinical reasoning is best described as the thin line between a patient’s death or deteriorating health status and recovery. Nurses or clinicians with poor clinical reasoning place a patient’s health condition at risk of deterioration and in a lot of cases, death.

The New South Wales Health Incident Management in the NSW Public Health System 2007 noted that the three leading causes of adverse patient health outcomes include failure of clinicians to diagnose properly, failure to determine and initiate appropriate treatment plan, and poor management of complications, all three of which are a result of poor clinical reasoning.

The benefits of having sound clinical reasoning include making timely diagnoses, making prompt life-saving treatment plans, avoiding unnecessary investigations which reduces cost for the patient, and ultimately improving the patient’s health condition.

All of your training and education as a doctor, a nurse, or as a healthcare professional ultimately leads to your ability to practice clinical reasoning effectively. Any mistake or lapse in judgment can result in potential harm and even death to the patient.

A final thought

By and large, clinical reasoning refers to how well a clinician or nurse utilizes his clinical knowledge, understanding about the local culture, and medical ethics to make an accurate assessment of a patient’s condition and initiate the best course of action. Clinical reasoning is a learned skill that should be incorporated into clinical education and honed with further training and experience. What makes a good clinician or nurse is not just his or her fund of knowledge, but how well they can apply it.