Clinical reasoning can be defined as thinking through the various aspects of patient care to arrive at a reasonable decision regarding the prevention, diagnosis, or treatment of a clinical problem in a specific patient. Patient care includes history taking, conducting a physical exam, ordering laboratory tests and diagnostic procedures, designing safe and effective treatment regimens or preventive strategies, and providing patient education and counseling. Obviously, the clinician should be well grounded in biomedical and clinical sciences and skillful at gathering clinical data from a patient before engaging in the process of clinical reasoning. This guide is intended to help clinicians take the next step, which is determining the best course of action to take based on what is known or what can reasonably be hypothesized from clinical data. So, it isn’t enough to have a strong background in the biomedical sciences or to possess excellent clinical knowledge, nor to know how to conduct a history and physical exam on a patient, or even to know how to formulate a differential diagnosis given the signs, symptoms, and test results of a patient. In addition to all of this, there is still a need to think critically about all the important information pertaining to a particular case and to formulate or synthesize
a rational plan of action. In short, clinical reasoning requires critical thinking skills, abilities and traits which are often not taught in schools and colleges for the health professions.

Skilled clinicians systematically analyze their thinking by targeting the elements of clinical reasoning and evaluate their thinking through application of intellectual standards to those elements. These clinicians also develop and routinely exhibit intellectual traits or dispositions of mind. When these foundations of critical thinking – the elements of reasoning, intellectual standards, and intellectual traits – are made explicit and deeply understood, the clinician has explicit intellectual tools useful for examining, assessing and improving thought. This guide introduces the clinician to these foundations and offers examples of their application to the field.