Affiliations 

  • 1 Department of Neurosurgery, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan
  • 2 Medical Education Research Center, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan
  • 3 Department of Medical Education, Faculty of Medicine, University of Kelaniya, Kelaniya, Taiwan
  • 4 Department of Family Medicine and Primary Care (FMPC) and Bau Institute of Medical and Health Sciences Education (BIMHSE), The University of Hong Kong, Hong Kong, China
  • 5 Center for Medical Education, Graduate School of Medicine, Nagoya University, Nagoya, China
  • 6 World Health Organization, Geneva, Switzerland
  • 7 Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Gelugor, Malaysia
  • 8 School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Level 7, Susan Wakil Health Building D18, Sydney, NSW, 2006, Australia. lynn.monrouxe@sydney.edu.au
Adv Health Sci Educ Theory Pract, 2021 Dec;26(5):1555-1579.
PMID: 34254202 DOI: 10.1007/s10459-021-10060-z

Abstract

Clinical reasoning is the thought process that guides practice. Although a plethora of clinical reasoning studies in healthcare professionals exists, the majority appear to originate from Western cultures. A scoping review was undertaken to examine clinical reasoning related research across Asian cultures. PubMed, SciVerse Scopus, Web of Science and Airiti Library databases were searched. Inclusion criteria included full-text articles published in Asian countries (2007 to 2019). Search terms included clinical reasoning, thinking process, differential diagnosis, decision making, problem-based learning, critical thinking, healthcare profession, institution, medical students and nursing students. After applying exclusion criteria, n = 240 were included in the review. The number of publications increased in 2012 (from 5%, n = 13 in 2011 to 9%, n = 22) with a steady increase onwards to 12% (n = 29) in 2016. South Korea published the most articles (19%, n = 46) followed by Iran (17%, n = 41). Nurse Education Today published 11% of the articles (n = 26), followed by BMC Medical Education (5%, n = 13). Nursing and Medical students account for the largest population groups studied. Analysis of the articles resulted in seven themes: Evaluation of existing courses (30%, n = 73) being the most frequently identified theme. Only seven comparative articles showed cultural implications, but none provided direct evidence of the impact of culture on clinical reasoning. We illuminate the potential necessity of further research in clinical reasoning, specifically with a focus on how clinical reasoning is affected by national culture. A better understanding of current clinical reasoning research in Asian cultures may assist curricula developers in establishing a culturally appropriate learning environment.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.