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Clinical reasoning: perceptions and practices of medical students

Abstract:

Introduction:

In times of constant correction of funding for the maintenance of the Sistema Único de Saúde (SUS), it is necessary to focus on medical practice, especially with regard to the high cost that the unnecessary use of complementary tests causes to public health.

Objective:

To analyze perceptions and practices in clinical reasoning (CR) of medical students at a public university in northeastern Brazil.

Methods:

Qualitative research, conducted with 12 medical students (MS). Data was collected through semi-structured interviews with audio recording. Data analysis was performed using the method of thematic content analysis.

Results:

Most MS understood clinical reasoning as a synonym for diagnostic reasoning, and CR practice as a combination of anamnesis data, physical exam and complementary exams. They perform therapeutic reasoning based on aspects such as patient diagnosis, symptoms, comorbidities, allergies and therapeutic compliance; and demonstrated superficial theoretical-conceptual knowledge of the topic.

Conclusion:

The perceptions and practices of MS on CR revealed relevant aspects of the practical context of the internship at the university. The study, therefore, supports new discussions and opportunities for new research on the topic.

Keywords:
Medical Education; Clinical Competence; Clinical Decision-Making; Diagnosis; Therapeutics

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