Experts have reduced the steps in clinical reasoning to an unconscious process involving the following steps:
Identification of information that is clinically relevant to a
Proper interpretation of the information
Development of hypotheses with a coherent explanation of the findings
Refinement of hypotheses with targeted data collection
Establishment of a working diagnosis
The expert level of clinical reasoning is achieved only after years of practice. Characteristics of experts include:
Experts are superior in knowledge content, not basic mental capacities, and remember factual knowledge better.
Experts use critical thinking in their area of specialty, with better problem representations (schemes or patterns of recognition).
Experts work forward from the information they have. They are more able to filter extract relevant information from available data and to generate meaningful hypotheses.
Experts have become experts through extensive practice (10,000 hours) building a body of knowledge, strategies, and experiences accumulated over many years.
Experts do not tend to use knowledge of basic sciences in arriving at a diagnosis. Biomedical knowledge can be used as a check on the validity of a diagnosis. Experts can apply biomedical knowledge as needed.
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Groves M, O'Rourke P, Alexander H. Clinical reasoning: the relative contribution of identification, interpretation and hypothesis errors to misdiagnosis. Med Teach. 2003;25(6):621-5.