IOSR Journal Of Humanities And Social Science (IOSR-JHSS) Volume 22, Issue 9, Ver. 4 (September. 2017) PP 38-43 e-ISSN: 2279-0837, p-ISSN: 2279-0845. www.iosrjournals.org DOI: 10.9790/0837-2209043843 www.iosrjournals.org 38 | Page Clinical Reasoning Models Used By Medical Students and Physicians in a Public University in Mexico * Crisanto Martínez-Méndez 1 , Arturo García-Rillo 1*, Jocelyn García-Alvarado 1 , Beatriz Elina Martínez-Carrillo 1 1 Faculty of Medicine, Universidad Autónoma del Estado de México, Paseo Tollocan esq. Jesús Carranza, Col. Corresponding Author: Arturo García-Rillo Abstract: Clinical reasoning (CR) is a central part of medicine where the knowledge, skills and techniques of the physician are solidified in practice. The epistemological bases of CR are those that support the way that the physician utilizes knowledge. Three models of CR have been identified: intuitive, empirical and theoretical; the efficiency and type of reasoning will depend on the model adopted. A survey was carried out in six populations with different educational degrees, from undergraduate students to postgraduate physicians. The results indicated that the theoretical model is the prevailing model with the highest level of affinity by the subjects in the study. It was also revealed that there are significant differences in theoretical and empirical models, but not in the intuitive model. Furthermore, it was identified that a negative correlation exists between the levels of education and the models of reasoning: physicians with more advanced degrees, which translated to more years of experience, have a lower affinity for the theoretical and empirical models. Keywords: Clinical reasoning, reasoning models, intuitive model, empirical model, theoreticalmodel. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 30-08-2017 Date of acceptance: 08-09-2017 --------------------------------------------------------------------------------------------------------------------------------------- I. INTRODUCTION CR is an important aspect of the profession that helps faculty solve medical problems, draw conclusions and consciously learn from the facts, establishing necessary causal and logical connections between them [1] . CR is the foundation for a physician’s decision-making; it has a vital impact, since the quality of life of patients is determined by a physician’s diagnosis and treatment [2-4] . CR combines medical and clinical knowledge, but it can also present an inherent problem in that it is never finished, but rather an act of continuous improvement. The job of the professional is to adopt an effective form of CR, while the teachers in the health sciences are responsible for transmitting, developing and refining that reasoning [1] , so any attempt to enrich it is valuable. The epistemological basis of CR allows to recognize the nature of knowledge, involved in the process of obtaining the medical diagnosis. Two of the major problems of epistemology, namely, the possibility and origin of knowledge [5] are present in CR. The first epistemological problem is clearly resolved, physicians consider that it is possible to know, otherwise, medical work would not make sense, since doctors assume that they can identify the disease that people suffer or, therefore less, it is possible [6] . The second problem, corresponding to the origin of knowledge, questions whether this process arises out of reason, experience or intuition? The possible answers to this question have been addressed in the models, specifically in the so-called Clinical Reasoning Models (CRM), which are commonly divided into the two groups of analytical and non- analytical models [7,8] , but there are elements which suggest the intuitive model [9] is a third option. The analytical CRM (also known as theoretical) carefully analyze the relationship between symptoms and signs, to obtain an objective diagnosis derived from some verifiability test [2] . The characteristics of this model are that it uses hypothetical-deductive thinking and it is slow in arriving at the diagnosis, given the level of care and attention it requires and the series of systematic steps that must be taken. In addition, the analytical model must be based on scientific evidence [10-16] . The non-analytical CRM (also called the empirical) refers to the model centered on the physician’s experience as a source of knowledge and guidance for CR. It is characterized by the recognition of patterns obtained from the experience of practicing medicine. In addition, it is a fast and semi-automatic process, which may not require full consciousness, which puts it at a greater risk of error [2] . This is the model of medical expertise which is usually associated with the most experienced, long-term doctors [12-16] , in whom repeated