The psyhology of practical thinking among physicians and nurses

Abstract

Medicine as a practice; medicine: science or art, or, art and science? medicine and artificial intelligence systems; the complexity of clinical rationality; the radical uncertainty of clinical practice; a science of individuals?; why does medicine collude in the misrepresentation of its rationality? medical educators and the misrepresentation of medicine, medicine's irreducible uncertainty and the over-reliance on science; clinical judgment and the interpretation of the individual case; doctors do not reason as scientists do, generalization and particularization; every lion is different; EBM, the individual and the exercise of clinical judgment; EBM, clinical judgment and ‗Feinsteinian‘ thinking; clinical reasoning: far more situated and flexible than even the most complex clinical algorithm; clinical knowing – "Don't think zebras", "The research shows … and in my experience …", habits of practice; the overarching paradox of medicine's theory of knowledge; counterbalancing as a practical theory of clinical rationality.