A new integrated model of clinical reasoning: development, description and preliminary assessment in patients with stroke

Disabil Rehabil. 2007 Jul 30;29(14):1129-38. doi: 10.1080/09638280600948318.


Purpose: The main objective was the development and collection of preliminary data on the application of a new integrated clinical reasoning model (Anadysis) with patients suffering a stroke or Transient Ischemic Attack (TIA).

Method: Twelve healthcare professionals working in the neurological and the Accident and Emergency (A&E) units of an acute general hospital participated and experimental control was achieved by employing a pre-test post-test control group experimental design. Members of the control group used the current reasoning model of their discipline whereas the new integrated model was used by the members of the experimental group irrespective of their professions. Outcomes were measured by scoring on a protocol derived from the UK National Clinical Guidelines for Stroke divided into the three main clinical reasoning processes.

Results: Collectively, data from 186 protocols based on the medical records of 49 patients showed that median percentages of correct responses in clinical reasoning were substantially higher for the experimental group by using the new integrated model.

Conclusions: This study will inform the healthcare professionals about a new effective integrated clinical reasoning model which incorporates the complex processes of diagnosis, planning and treatment as a whole. This study may also become an important consideration in the further development of clinical decision support systems within the scientific area of health informatics.

MeSH terms

  • Case Management*
  • Decision Support Systems, Clinical*
  • Health Personnel / psychology
  • Humans
  • Inservice Training
  • Ischemic Attack, Transient / therapy*
  • Stroke / therapy*
  • United Kingdom