Peter Woodford
Journal of Paramedic Practice, Vol. 7, Iss. 2, 06 Feb 2015, pp 90 - 94

The paramedic role requires countless sound, logical and sensible decisions to be made. Sometimes paramedics may be faced with decisions that they feel less confident about making. This paper will discuss the types of clinical decision-making approaches. The majority of everyday decisions are made intuitively. The brain uses its experience to match decisions that it has made, observed or contributed. This may not be a reliable method of decision making, especially if you have been unable to gather sufficient information. Pattern recognition is a skill-based activity. Unlike intuition, which can support near-instant decision making, it is done when time permits and there is no need to rush. Under the hypothetico-deductive model of clinical decision making, the clinician sorts the clues and findings into logical groups using previous knowledge of symptoms and anatomical locations and landmarks. Then a hypothesis is formulated based on experience and knowledge of pathological, physiological and psychological conditions. Generally, clinicians need to improve their awareness of clinical decision making: using intuition might well have a role to play coupled with heuristics and bias, but it has its limitations and risks. However, hypothetico-deductive reasoning has a prominent place and should be embedded into education and everyday use.

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