Document Detail


Clinical judgement, expertise and skilled coping.
MedLine Citation:
PMID:  20367849     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Medicine involves specific practical expertise as well as more general context-independent medical knowledge. This raises the question, what is the nature of the expertise involved? Is there a model of clinical judgement or understanding that can accommodate both elements? This paper begins with a summary of a published account of the kinds of situation-specific skill found in anaesthesia. It authors claim that such skills are often neglected because of a prejudice in favour of the 'technical rationality' exemplified in evidence-based medicine but they do not themselves offer a general account of the relation of practical expertise and general medical knowledge. The philosopher Hubert Dreyfus provides one model of the relation of general knowledge to situation-specific skilled coping. He claims that the former logically depends on the latter and provides two arguments, which I articulate in the second section, for this. But he mars those arguments by building in the further assumption that such situation-specific responses must be understood as concept-free and thus mindless. That assumption is held in place by three arguments all of which I criticize in the next section to give a unified account of clinical judgement as both practical and conceptually structured and thus justified in the face of a prejudice in favour of 'technical rationality'.
Authors:
Tim Thornton
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of evaluation in clinical practice     Volume:  16     ISSN:  1365-2753     ISO Abbreviation:  J Eval Clin Pract     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-06     Completed Date:  2010-07-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609066     Medline TA:  J Eval Clin Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  284-91     Citation Subset:  IM    
Affiliation:
International School for Communities Rights and Inclusion, University of Central Lancashire, Preston, UK. tthornton1@uclan.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Anesthesia / standards
Clinical Competence*
Humans
Judgment*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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