Personal Narrative: Improving Clinical Reasoning

To enhance my clinical knowledge I take time to understand why I am doing a task a particular way

Reflection has its importance in clinical practice; we always seek to be successful and that can be achieved by learning every day of our life through experiences we encounter. In that way we can reconsider and rethink our previous knowledge and add new learning to our knowledge base so as to inform our practice. Learning new skills does not stop upon qualifying; this should become second nature to thinking professionals as they continue their professional development throughout their careers (Jasper, 2006).

Week three in clinical was difficult for me, I had a great experience overall but I hated seeing and holding a baby that had passed away at 21 weeks. To know what the family could possibly be going through was heartbreaking. I wouldn’t exactly know what to do if I was with the patient and her family exactly. I do know that I did place her in the room when she was admitted to triage. I do feel good about seeing the scenario play out, while being a student rather than being in the field alone. Other than that I was able to see the beginning stage of labor as well as a C-section. Everyone was so bent out of shape on making sure I eat and that I don’t faint, but it seriously wasn’t bad. As a matter of fact I was too intrigued with the mother rather

I have had multiple clinical practices, however, out of all the experiences during my shifts, there is one particular event that holds great meaning for me. This event happened on my fifth clinical day of this semester, which was the day I first dealt with two clients.

One of the competency dimensions for a health care provider is clinical reasoning. In other words, clinical reasoning is one of the core competencies that guides clinical practice of any health care professional. Berman, Snyder, and Frandsen (2015) defined clinical reasoning as a cognitive process in which a clinician utilizes “thinking strategies to gather and analyze client information, evaluate the relevance of the information, and decide on possible nursing actions to improve the client’s physiological and psychosocial outcomes” (p. 144). Levett-Jones et al. (2009) described clinical reasoning as a course of clinical encounters during which clinician collects patient information, processes it and generates an understanding of what is happening with the patient, what is the problem, and only then makes appropriate interventions and evaluates the results. It is important to note that competency and clinical reasoning are the major attributions of a good health

If I were a psychoanalyst treating disorders, I would deal with the behavioral aspect of the disorder. With the behavioral point of view, it involves a multitude of developments such as phobias, anxiety, and other various situations. I personally like the behavioral aspect the most because it starts by taking on a certain person’s fear with the same ways it was originally developed. For instance, say somebody has a social phobia and cannot handle being in certain places due to a large amount of people, this individual may love sports but will not go to events due to high volumes of people which results to watching all games on TV. I would simply start to figure out why this all began, then slowly bring in different solutions. One way could

I shadowed multiple physicians from various specialties, as I worked to confirm my desire to become a physician. Out of all of them, Dr. Brian Loveless, a family practice physician who utilizes osteopathic manipulative medicine, stood out to me the most. My time shadowing him at The Patient Care Center at Western University of Health Sciences exposed me to the philosophy of osteopathic medicine. Using osteopathic manipulative treatment techniques like high-velocity, low-amplitude, he was able to relieve patients of their pains or aches during the visit, without providing any medications. It was these moments that taught me the effectiveness about the philosophy of osteopathic medicine. As Dr. Loveless stated regarding one patient, he was treating

According to Hawkins, Elder, & Paul (2010) Clinical reasoning is “thinking through the various aspects of patient care to arrive at a reasonable decision regarding the prevention, diagnoses, or treatment of a clinical problem in a specific patient” (p. 3.) The

During the feedback conversation with my supervisor I started to realize that, I was not able to support my opinion. During this conversation I started to feel frustrated and disappointed with myself. It was shocked because I didn’t expect to be so hard to put all the information that came from the patient in the right order to make the correct decision and I was afraid that I couldn’t learn how to come to a conclusion never in my life. Throughout the conversation, my supervisor mentioned the words Clinical Reasoning and Diagnostic Clinical Reasoning which was something new for me. From that time, she gave me the stimulus to look more around that area with the aim to improve my clinical reasoning skill and to get diagnostic reasoning thinking.

Medical education stimulates development clinical reasoning in medical students and residents to be able making the correct diagnosis for their patients. Clinical reasoning process in doctors develops through the time which gives them more competency to do that as experts. However, it is not known which instructional strategies that would improve clinical reasoning process in doctors. Such strategy makes medical students and residents think more effective like experts. This study focused on effects of using structured reflection on clinical reasoning process in a medical residents training program.

Often times, healthcare professionals are handicapped by their solely technical assessment of their patients. To

By being a patient myself, I understood that physiotherapists should have good information gathering and assessing skills, along with being friendly and at the same time show discretion, allowing the patient to feel at ease when sharing personal information, in order for them to provide the right treatment. When attending an observation day I learned that they work in a variety of settings and departments, such as outpatient, stroke or paediatric, along

This theory was applied to a client that had a diagnosis of intervertebral disc prolapse. The client was in severe pain. 1) Orientation phase; the client was initially reluctant to talk due to her pain. 2) Identification phase; the client expresses the need to get relief from pain. The nurse educates the client on the pain scale to measure pain. 3) Exploitation phase; client informs nurse that there is relief from pain when she is in the supine position. 4) Resolution phase – client’s pain was reduced and tolerable.

Patient examination in physical therapy includes measures such as strength, flexibility, range of motion, motor function, and quality of life. After all of this has been done, a physical therapist uses clinical reasoning to determine what is wrong with the patient and what should be done to help the patient improve. He uses the gathered information to develop an individualized care plan for each patient, indicating the patient’s short- and long-term goals and expected outcomes as a result of the therapy sessions (U.S. Bureau, 2015).

Common strategies are designed to enhance self-esteem and confidence and build therapeutic momentum as patients gain energy, feel better, and disconfirm negative beliefs. ABC technique help highlight situations that evoke evaluations which in turn provoke emotional and behavioural reactions. Behavioural experiments can be used to check out the validity of predictions and beliefs. Questionnaires, thought records (NAT’s) and mood diaries help increase self awareness and give concrete evidence of improvement, or if there are no changes, treatment can be adapted. Goal setting or activity scheduling all aid practical problem solving and physical interventions can include relaxation techniques, physical exercise and or appraisal of sleeping problems and In vivo exposure entails confronting the patient with the avoided object or situation. The Socratic questioning contains elements of the learning cycle and alerts clients to observe their experiences (observation); develop new understandings of their problems (reflection); synthesise new possibilities and ways forward (planning new experiences). In other words cognitive techniques help the client create insights and possibilities (observation-reflection-planning) which are tested in the field (experience). By linking experience and cognition a more affective behavioural