Enhancing therapeutic reasoning: key insights and
recommendations for education in prescribing

J 2024

Enhancing therapeutic reasoning: key insights and recommendations for education in prescribing

HARTJES, Marielle G; Milan C RICHIR; Yoann CAZAUBON; Erik M DONKER; van Leeuwen ELLEN et. al.

Základní údaje

Originální název

Enhancing therapeutic reasoning: key insights and recommendations for education in prescribing

Autoři

Vydání

BMC Medical Education, London, BMC, 2024, 1472-6920

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30104 Pharmacology and pharmacy

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.700 v roce 2023

Kód RIV

RIV/00216224:14110/24:00138478

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1186/s12909-024-06310-4

UT WoS

001363453300004

EID Scopus

2-s2.0-85210161073

Klíčová slova anglicky

Therapeutic reasoning; Medical decision making; Clinical pharmacology and therapeutics; Medical education; Management reasoning; Clinical competency

Štítky

14110516, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 15. 1. 2025 09:26, Mgr. Tereza Miškechová

Anotace

V originále

BackgroundDespite efforts to improve undergraduate clinical pharmacology & therapeutics (CPT) education, prescribing errors are still made regularly. To improve CPT education and daily prescribing, it is crucial to understand how therapeutic reasoning works. Therefore, the aim of this study was to gain insight into the therapeutic reasoning process.MethodsA narrative literature review has been performed for literature on cognitive psychology and diagnostic and therapeutic reasoning.ResultsBased on these insights, The European Model of Therapeutic Reasoning has been developed, building upon earlier models and insights from cognitive psychology. In this model, it can be assumed that when a diagnosis is made, a primary, automatic response as to what to prescribe arises based on pattern recognition via therapy scripts (type 1 thinking). At some point, this response may be evaluated by the reflective mind (using metacognition). If it is found to be incorrect or incomplete, an alternative response must be formulated through a slower, more analytical and deliberative process, known as type 2 thinking. Metacognition monitors the reasoning process and helps a person to form new therapy scripts after they have chosen an effective therapy. Experienced physicians have more and richer therapy scripts, mostly based on experience and enabling conditions, instead of textbook knowledge, and therefore their type 1 response is more often correct.ConclusionBecause of the important role of metacognition in therapeutic reasoning, more attention should be paid to metacognition in CPT education. Both trainees and teachers should be aware of the possibility to monitor and influence these cognitive processes. Further research is required to investigate the applicability of these insights and the adaptability of educational approaches to therapeutic reasoning.

Citovat

HARTJES, Marielle G; Milan C RICHIR; Yoann CAZAUBON; Erik M DONKER; van Leeuwen ELLEN; Robert LIKIC; Yves-Marie PERS; Joost D PIET; De Ponti FABRIZIO; Walter RAASCH; van Rosse FLOOR; Jitka RYCHLÍČKOVÁ; Emilio J SANZ; Markus SCHWANINGER; Susanna M WALLERSTEDT; Theo P G M DE VRIES; Michiel A VAN AGTMAEL a Jelle TICHELAAR. Enhancing therapeutic reasoning: key insights and recommendations for education in prescribing. BMC Medical Education. London: BMC, 2024, roč. 24, č. 1, s. 1-14. ISSN 1472-6920. Dostupné z: https://dx.doi.org/10.1186/s12909-024-06310-4.

@article{2468158,
   author = {Hartjes, Marielle G and Richir, Milan C and Cazaubon, Yoann and Donker, Erik M and Ellen, van Leeuwen and Likic, Robert and Pers, YvesandMarie and Piet, Joost D and Fabrizio, De Ponti and Raasch, Walter and Floor, van Rosse and Rychlíčková, Jitka and Sanz, Emilio J and Schwaninger, Markus and Wallerstedt, Susanna M and de Vries, Theo P G M and van Agtmael, Michiel A and Tichelaar, Jelle},
   article_location = {London},
   article_number = {1},
   doi = {http://dx.doi.org/10.1186/s12909-024-06310-4},
   keywords = {Therapeutic reasoning; Medical decision making; Clinical pharmacology and therapeutics; Medical education; Management reasoning; Clinical competency},
   language = {eng},
   issn = {1472-6920},
   journal = {BMC Medical Education},
   title = {Enhancing therapeutic reasoning: key insights and recommendations for education in prescribing},
   url = {https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-024-06310-4},
   volume = {24},
   year = {2024}
}

TY  - JOUR
ID  - 2468158
AU  - Hartjes, Marielle G - Richir, Milan C - Cazaubon, Yoann - Donker, Erik M - Ellen, van Leeuwen - Likic, Robert - Pers, Yves-Marie - Piet, Joost D - Fabrizio, De Ponti - Raasch, Walter - Floor, van Rosse - Rychlíčková, Jitka - Sanz, Emilio J - Schwaninger, Markus - Wallerstedt, Susanna M - de Vries, Theo P G M - van Agtmael, Michiel A - Tichelaar, Jelle
PY  - 2024
TI  - Enhancing therapeutic reasoning: key insights and recommendations for education in prescribing
JF  - BMC Medical Education
VL  - 24
IS  - 1
SP  - 1-14
EP  - 1-14
PB  - BMC
SN  - 14726920
KW  - Therapeutic reasoning
KW  - Medical decision making
KW  - Clinical pharmacology and therapeutics
KW  - Medical education
KW  - Management reasoning
KW  - Clinical competency
UR  - https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-024-06310-4
N2  - BackgroundDespite efforts to improve undergraduate clinical pharmacology & therapeutics (CPT) education, prescribing errors are still made regularly. To improve CPT education and daily prescribing, it is crucial to understand how therapeutic reasoning works. Therefore, the aim of this study was to gain insight into the therapeutic reasoning process.MethodsA narrative literature review has been performed for literature on cognitive psychology and diagnostic and therapeutic reasoning.ResultsBased on these insights, The European Model of Therapeutic Reasoning has been developed, building upon earlier models and insights from cognitive psychology. In this model, it can be assumed that when a diagnosis is made, a primary, automatic response as to what to prescribe arises based on pattern recognition via therapy scripts (type 1 thinking). At some point, this response may be evaluated by the reflective mind (using metacognition). If it is found to be incorrect or incomplete, an alternative response must be formulated through a slower, more analytical and deliberative process, known as type 2 thinking. Metacognition monitors the reasoning process and helps a person to form new therapy scripts after they have chosen an effective therapy. Experienced physicians have more and richer therapy scripts, mostly based on experience and enabling conditions, instead of textbook knowledge, and therefore their type 1 response is more often correct.ConclusionBecause of the important role of metacognition in therapeutic reasoning, more attention should be paid to metacognition in CPT education. Both trainees and teachers should be aware of the possibility to monitor and influence these cognitive processes. Further research is required to investigate the applicability of these insights and the adaptability of educational approaches to therapeutic reasoning.
ER  -

HARTJES, Marielle G; Milan C RICHIR; Yoann CAZAUBON; Erik M DONKER; van Leeuwen ELLEN; Robert LIKIC; Yves-Marie PERS; Joost D PIET; De Ponti FABRIZIO; Walter RAASCH; van Rosse FLOOR; Jitka RYCHLÍČKOVÁ; Emilio J SANZ; Markus SCHWANINGER; Susanna M WALLERSTEDT; Theo P G M DE VRIES; Michiel A VAN AGTMAEL a Jelle TICHELAAR. Enhancing therapeutic reasoning: key insights and recommendations for education in prescribing. \textit{BMC Medical Education}. London: BMC, 2024, roč.~24, č.~1, s.~1-14. ISSN~1472-6920. Dostupné z: https://dx.doi.org/10.1186/s12909-024-06310-4.

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