Clinical reasoning is a key skill underpinning clinical decision-making processes and eventually clinicians’ expertise. Clinical reasoning in practice is an essential skill for our physical therapists/clinicians and a crucial step mandatory to enhance the reasoning skills to help our patients.
Four components identify a properly structured clinical reasoning: cue acquisition, hypothesis generation, cue interpretation, and hypothesis evaluation.
The aim with the clinical reasoning is to apply the acquired skills in a critical fashion, avoiding or at least being aware of the assumptions being made, then doing the best for our patients and our community/society through a shared decision-making process in an evidence-based environment.
That means that our physical therapists/clinicians promote a process based on communicating information about treatment options to patients/athletes. At the same, our patients/athletes communicate their involved expectations/beliefs/ideas/etc. so that an agreement on the best treatment strategy in the best interest of the patient can be reached.
Clinical reasoning and evidence-based decision making combined generate a process in which care decisions are optimized by bringing all of these perspectives together, in an ethical environment.
This was feasible in our physical therapy centers because we are consistently recording objective patients' outcomes to track and validate our interventions results. All the information is analyzed and then the best possible evidence-based rehabilitation program is tailored on each patient. This is also relevant from a financial standpoint, since we practice in an insurance-based healthcare system in which there are no free state-provided health services, but mandatory private health insurances. Justifying the need for further intervention providing the objective proof of the achievement of previous goals is mandatory.
A properly structured clinical reasoning makes easier for physical therapists and clinicians to do the “right thing” to the “right patient” at the “right moment”. It can also help in assembling specialized and skilled teams around certain major health issues/diseases in need of the attention of a whole team and not just one physical therapist, creating a “squad” in support of a single patient.