for Clinical Accuracy:
The Columbia Cooperative Aging Program (CCAP) teaches medical residents to use "Comprehensive Clinical Reasoning" (CCR) to organize results of their extended interviews with "well" older adults. CCR is comprised of five distinct modes of clinical reasoning which are further described (with narrative examples) in the Instructor Notes File. While procedural reasoning (i.e. generating hypotheses regarding the causes of patients, illnesses or disabilities, as well as selecting diagnostic and treatment approaches and procedures) typically dominates the education of physicians in training, we stress several additional domains of clinical reasoning including:
interactive reasoning (using dialogue to build rapport with patients; eliciting their attitudes, values and interests);
narrative reasoning (eliciting, re-telling, and interpreting patients' stories to acknowledge and represent their lives in the context of current conditions);
pragmatic (or reflective) reasoning (considering the environmental and social factors affecting the patient's health and function, including each provider's own idiosyncrasies that might be influencing the outcome of treatment); and
integrative (or conditional) reasoning (synthesizing the evaluation results, incorporating the current and potential impacts of bio-psychosocial factors affecting the patients' health).
Format: Case-based teaching
Basic understanding of the utility of comprehensive clinical reasoning to organize extensive bio-psycho-social information about "well" older adult cases.
Learners will identify 5 modes of Comprehensive Clinical Reasoning
Learners will give examples of each mode of clinical reasoning
Additional information/Special implementation requirements or guidelines:
120 medical interns during their geriatric rotation's "well" elder sessions.
Date Submitted or Reviewed/Updated for Clinical Accuracy:
, , , , and . CCAP Comprehensive Clinical Reasoning. POGOe - Portal of Geriatrics Online Education; 2006 Available from: https://pogoe.org/taxonomy/term/249