Too much versus too little: looking for the “sweet spot” in optimal use of diagnostic investigations

Scott, Ian A; Crock, Carmel; Twining, Matthew

doi:10.5694/mja2.52193

Medical Journal of Australia

2023

DOI: 10.5694/mja2.52193

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Too much versus too little: looking for the “sweet spot” in optimal use of diagnostic investigations

Ian A Scott,

Carmel Crock,

Matthew Twining

Abstract: Balancing underuse and overuse of investigations in the diagnostic process MJA 220 (2) ▪ 5 February 2024 Perspectives Open access: Open access publishing facilitated by The University of Queensland, as part of the Wiley -The University of Queensland agreement via the Council of Australian University Librarians.

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Clinical reasoning in real-world practice: a primer for medical trainees and practitioners

Ng,

Goh,

Teo

et al. 2024

Postgraduate Medical Journal

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Clinical reasoning is a crucial skill and defining characteristic of the medical profession, which relates to intricate cognitive and decision-making processes that are needed to solve real-world clinical problems. However, much of our current competency-based medical education systems have focused on imparting swathes of content knowledge and skills to our medical trainees, without an adequate emphasis on strengthening the cognitive schema and psychological processes that govern actual decision-making in clinical environments. Nonetheless, flawed clinical reasoning has serious repercussions on patient care, as it is associated with diagnostic errors, inappropriate investigations, and incongruent or suboptimal management plans that can result in significant morbidity and even mortality. In this article, we discuss the psychological constructs of clinical reasoning in the form of cognitive ‘thought processing’ models and real-world contextual or emotional influences on clinical decision-making. In addition, we propose practical strategies, including pedagogical development of a personal cognitive schema, mitigating strategies to combat cognitive bias and flawed reasoning, and emotional regulation and self-care techniques, which can be adopted in medical training to optimize physicians’ clinical reasoning in real-world practice that effectively translates learnt knowledge and skill sets into good decisions and outcomes.

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Clinical reasoning in real-world practice: a primer for medical trainees and practitioners

Ng,

Goh,

Teo

et al. 2024

Postgraduate Medical Journal

View full text Add to dashboard Cite

show abstract

Editorial: Navigating low‐value care in regional, rural and remote Australia

Thomas,

Gangathimmaiah,

Coates

et al. 2024

Australian J Rural Health

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Too much versus too little: looking for the “sweet spot” in optimal use of diagnostic investigations

Cited by 2 publications

References 31 publications

Clinical reasoning in real-world practice: a primer for medical trainees and practitioners

Clinical reasoning in real-world practice: a primer for medical trainees and practitioners

Editorial: Navigating low‐value care in regional, rural and remote Australia

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