The challenge of clinical reasoning in chronic multimorbidity: time and interactions in the Health Issues Network model
Author:
Consorti Fabrizio1ORCID, Torre Dario2, Luzi Daniela3, Pecoraro Fabrizio3, Ricci Fabrizio3, Tamburis Oscar4
Affiliation:
1. Associate Professor of Surgery , University of Rome “La Sapienza” Medical School , Rome , Italy 2. Professor of Medicine , University of Central Florida , Orlando , FL , USA 3. Institute for Research on Population and Social Policies, National Research Council , Rome , Italy 4. Department of Veterinary Medicine and Animal Productions , University of Naples Federico II , Naples , Italy
Abstract
Abstract
The increasing prevalence of multimorbidity requires new theoretical models and educational approaches to develop physicians’ ability to manage multimorbidity patients. The Health Issues Network (HIN) is an educational approach based on a graphical depiction of the evolutions over time of the concurrent health issues of a patient and of their interactions. From a theoretical point of view, the HIN approach is rooted in Prigogine’s vision of the “becoming” of the events and in the concept of knowledge organization, intended as the process of storing and structuring of information in a learner’s mind. The HIN approach allows to design clinical exercises to foster learners’ ability to detect evolutionary paths and interactions among health issues. Recent findings of neuroscience support the expectation that interpreting, completing, and creating diagrams depicting complex clinical cases improves the “sense of time”, as a fundamental competence in the management of multimorbidity. The application of the HIN approach is expected to decrease the risk of errors in the management of multimorbidity patients. The approach is still under validation, both for undergraduate students and for the continuous professional development of physicians.
Publisher
Walter de Gruyter GmbH
Subject
Biochemistry (medical),Clinical Biochemistry,Public Health, Environmental and Occupational Health,Health Policy,Medicine (miscellaneous)
Reference24 articles.
1. Young, M, Thomas, A, Gordon, D, Gruppen, L, Lubarsky, S, Rencic, J, et al.. The terminology of clinical reasoning in health professions education: implications and considerations. Med Teach 2019;41:1277–84. https://doi.org/10.1080/0142159x.2019.1635686. 2. Norman, GR, Monteiro, SD, Sherbino, J, Ilgen, JS, Schmidt, HG, Mamede, S. The causes of errors in clinical reasoning: cognitive biases, knowledge deficits, and dual process thinking. Acad Med 2017;92:23–30. https://doi.org/10.1097/acm.0000000000001421. 3. Kudesia, P, Salimarouny, B, Stanley, M, Fortin, M, Terry, SM, Terry, A, et al.. The incidence of multimorbidity and patterns in accumulation of chronic conditions: a systematic review. J Comorbidity 2021;11:26335565211032880. https://doi.org/10.1177/26335565211032880. 4. Soh, M, Konopasky, A, Durning, SJ, Ramani, D, McBee, E, Ratcliffe, T, et al.. Sequence matters: patterns in task-based clinical reasoning. Diagnosis 2020;7:281–9. https://doi.org/10.1515/dx-2019-0095. 5. Ho, VP, Schiltz, NK, Reimer, AP, Madigan, EA, Koroukian, SM. High-risk comorbidity combinations in older patients undergoing emergency general surgery. J Am Geriatr Soc 2019;67:503–10. https://doi.org/10.1111/jgs.15682.
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