Institute of Health Sciences Education in the Faculty of Medicine, McGill University, Room 200 Lady Meredith House, 1110 Pine Avenue West, Montreal, QC, H3A 1A3, Canada.
School of Physical and Occupational Therapy, Institute of Health Sciences Education in the Faculty of Medicine at McGill University, Centre for Interdisciplinary Research in Rehabilitation of greater Montreal, Montréal, Canada.
BMC Med Educ. 2020 Apr 7;20(1):107. doi: 10.1186/s12909-020-02012-9.
Clinical reasoning is at the core of health professionals' practice. A mapping of what constitutes clinical reasoning could support the teaching, development, and assessment of clinical reasoning across the health professions.
We conducted a scoping study to map the literature on clinical reasoning across health professions literature in the context of a larger Best Evidence Medical Education (BEME) review on clinical reasoning assessment. Seven databases were searched using subheadings and terms relating to clinical reasoning, assessment, and Health Professions. Data analysis focused on a comprehensive analysis of bibliometric characteristics and the use of varied terminology to refer to clinical reasoning.
Literature identified: 625 papers spanning 47 years (1968-2014), in 155 journals, from 544 first authors, across eighteen Health Professions. Thirty-seven percent of papers used the term clinical reasoning; and 110 other terms referring to the concept of clinical reasoning were identified. Consensus on the categorization of terms was reached for 65 terms across six different categories: reasoning skills, reasoning performance, reasoning process, outcome of reasoning, context of reasoning, and purpose/goal of reasoning. Categories of terminology used differed across Health Professions and publication types.
Many diverse terms were present and were used differently across literature contexts. These terms likely reflect different operationalisations, or conceptualizations, of clinical reasoning as well as the complex, multi-dimensional nature of this concept. We advise authors to make the intended meaning of 'clinical reasoning' and associated terms in their work explicit in order to facilitate teaching, assessment, and research communication.
临床推理是卫生专业人员实践的核心。对临床推理构成要素的梳理可以支持跨卫生专业的临床推理教学、发展和评估。
我们开展了范围界定研究，在对临床推理评估的更大的最佳证据医学教育（BEME）综述背景下，梳理跨卫生专业文献中有关临床推理的文献。使用与临床推理、评估和卫生专业相关的副标题和术语对七个数据库进行了检索。数据分析侧重于对文献计量学特征的全面分析以及对用于指代临床推理的不同术语的使用。
确定的文献：跨越 47 年（1968-2014 年）的 625 篇论文，发表在 155 种期刊上，来自 544 位第一作者，涉及 18 个卫生专业。37%的论文使用了“临床推理”一词；还确定了 110 个用于指代临床推理概念的其他术语。就 6 个不同类别中的 65 个术语达成了术语分类共识：推理技能、推理表现、推理过程、推理结果、推理背景和推理目的/目标。不同卫生专业和出版物类型使用的术语类别存在差异。
存在许多不同的术语，且在文献背景下的使用方式也不同。这些术语可能反映了临床推理的不同操作或概念化，以及该概念的复杂、多维性质。我们建议作者在其工作中明确表示“临床推理”及其相关术语的含义，以促进教学、评估和研究交流。
