Here's how you can develop strong logical reasoning skills as a physician.

1. Assessing Patient History: When a patient presents with a problem, consider whether it might be an extension of or related to other known issues they have. Understanding the patient’s medical history and existing conditions can provide valuable context and help identify patterns or connections that might otherwise be overlooked. 2. Purposeful Diagnostic Testing: Think critically about how each diagnostic test will help you identify the root cause of the problem. Before ordering a test, clearly understand what information it will provide and how it will influence your diagnostic process. This approach ensures that each test has a specific purpose and contributes meaningfully to solving the clinical puzzle.

While teaching medical students it is not so easy to instill what comes natural to an experienced physician into usable guidelines and methods for better diagnosis and clarity in thought. Sometimes anatomic considerations help clarify the process. For extremities, start at the fingertips and work toward the neck or start at the toes and work towards the back. Then I asked the student to stretch the diagnosis by supposing other findings, tests, or labs are abnormal. In the teaching process we are always searching for ways to include the unusual diagnosis that may be missed. By Imagining an abnormal lab or test and its implications, that helps the student stretch the possible diagnoses, and creates incentives to rule things out.

Having Guidelines and processes for health care can support a good health system and good practices as these guidlines are prepared according to international practices and also developed by expertise in the field

- Uma coisa útil que identifico a cada vez mais, é o despreparo do médico recem formado, seja por falta de conhecimento técnico especifico , totalmente esperado para este perfil de profissional, quanto ao despreparo para lidar com com o publico, acolher, ter empatia, ouvir o doente.

It's that simple from diagnosis to symptoms as in deductive reasoning,from symptoms to diagnosis inductive... It's actually a very simple concept that explains how hypotheses are generated or tested. Keep going ,you've got this ??

Beware of premature closure. This is where you jump to a quick conclusion/diagnosis, especially because you notice “a pattern”. It can lead to diagnostic errors. Train your mind to always ask “what if” until you have evidence that strongly suggests or rules out diagnoses. Eg. A young woman on COCP and a recent long flight with chest pain and SOB is PE from the get go. What if it isn’t PE? Always be curious and ask questions not just to others, but to yourself.

Check the chart before going into the room and get familiar with the patient or refresh your memory . I always write on my last note what the plan is for the next visit plus some personal information like what name or nickname the pt prefers to be addressed as and some details about personal life and things happening in their lives so they see you are interested in them as a person as well . Your diagnostic process start when you or the pt enters the room and you observe their demeanor , mannerisms, etc . You can’t let the pt just ramble and have to direct the interview obviously but do not interrupt after just 15 seconds . On most cases if you listen and direct the questions the pt will give you the diagnosis without fancy tests .

Ask as many questions as you can while taking history from a patient. This will help you in exploring patients symptoms and reach a differential diagnosis. The questions should be relevant and focused.

Cultivate Curiosity: Constantly ask questions about patient care, treatment plans, and medical procedures. Questions like “Why is this treatment recommended?” or “What are the potential side effects?” can deepen your understanding. ? Engage with Mentors and Peers: Regularly discuss cases and medical topics with colleagues, mentors, and specialists. These conversations can provide new insights and perspectives.

Reflect Daily ? Case Review: At the end of each day, review the cases you encountered. Reflect on the decision-making process and the outcomes. ? Journaling: Keep a journal to document your reflections, noting what you learned and areas where you can improve. This practice can enhance your self-awareness and critical thinking. Note: Am currently reflecting on solutions to an upcoming very important special areas not even in my domain.

Challenge eg: Soldier: dropped & toe injury in army, >trained in agony. Threat no further medic. Back&leg hurt 5 years> wrong diagnosis, discharged & > ASD, PTSD Pains. Now mged, Live issues ST. No solicitor, To be deported???? Can GP Stop mgt ???? Is it Wrong question evidence based areas? Challenge medical law based 4 patient centred care to improve patient outcomes. Do Medical Rounds & Confrence, Participate in medical rounds, case conferences, and journal clubs. It’s ideal for engaging in debates & discussions about patient care & recent research. Challenge Assumptions: Don’t shy away from challenging assumptions and conventional wisdom. Respectfully question diagnoses and treatment plans to understand the rationale behind them.

Using case studies and realistic clinical scenarios to demonstrate the use and benefits of electronic medical records (EMRs) can significantly help in creating early adopters among physicians for several reasons: 1. **Concrete Evidence**: Case studies provide tangible proof of how EMRs have successfully improved patient care, streamlined workflows, and enhanced overall practice efficiency in real-world settings. This concrete evidence can be more convincing than theoretical benefits. 2. **Relatability**: Realistic clinical scenarios allow physicians to see how EMRs would function in their day-to-day operations.