Razonamiento clínico en medicina II: hacia una definición integradora
DOI:
https://doi.org/10.17533/10.17533/udea.iatreia.103Palabras clave:
errores médicos, procesos mentales, sesgo, teoría de las decisiones, toma de decisiones clínicasResumen
El entendimiento del razonamiento clínico es una necesidad para la investigación, la docencia y la práctica clínica. Los modelos teóricos subyacentes podrían agruparse en tres grandes ejes no excluyentes. El primero es denominado bayesiano informal según su estructura semejante al análisis de probabilidades condicionales. El segundo propone (desde las ciencias cognitivas) un razonamiento dual que es la suma de dos tipos de pensamientos: el tipo 1, rápido e intuitivo y, el tipo 2, hipotético-deductivo. El tercero, el conocimiento intersubjetivo que involucra la interacción del saber del paciente sobre su condición con el del médico, además, de hacer explícito el papel de la emoción. En esta segunda entrega se presenta una revisión narrativa de estas teorías para poder proponer una definición integradora, en la que se presenta al razonamiento clínico como un constructo complejo, iterativo y adaptativo.
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