Clinical Reasoning

Ask. Examine. Think. Revisit. Refine. Clerking order is a communication format — not a thinking process. Good clinicians loop.
This model explains how to do clerking in an iterative process.

Patients describe their experience in their language — not doctors' language.
This model explains how to listen to the patient's story, identify the relevant information, and structure it into a coherent clinical history.

Powerful discriminating questions outperform many vague ones. This model explains how to ask discriminating questions that will guide clinical reasoning and narrow the differential diagnosis and plan of management.

If you stop at the noun — you cannot diagnose.
This model explains how adjectives are not just embellishments — they are essential modifiers that can change the entire differential diagnosis.

Patients tell stories. Clinicians take histories.
This model explains how to listen to the patient's story, identify the relevant information, and structure it into a coherent clinical history.

The physical examination is not a ritualistic checklist. This model explains how to perform a focused examination that is guided by clinical reasoning and the patient's story — and how to avoid common pitfalls in clinical observation.

A good summary explains everything in a few sentences.
This model explains how to distill a complex clinical case into a concise summary that captures the essential information and guides clinical reasoning.

Severity is a clinical judgement.
This model explains the importance of assessing and communicating severity effectively to colleagues and seniors.

Uncertainty is a core part of clinical practice.
This model explains how to think about uncertainty in clinical reasoning and how to manage it effectively.

A step-by-step approach to differential diagnosis. Apply this to every diagnosis on your list. Rank, don't list. Consider negative findings. And always ask — why?

Symptoms are clues. Systems are hypotheses. Mechanism is the truth.
This model explains how to think about the origin of symptoms and avoid common pitfalls in clinical reasoning.

We investigate to answer questions.
This model explains decision making in doing investigations — from formulating a clinical question to choosing the right test to interpreting results in context.

Classify the state before you act. The acute flare is not bad luck — it is the consequence of failed maintenance. One model, every chronic disease.
This model explains how to classify patients into three clinical states — stable, flare, and recovery — and how to clerk each state effectively.

Recognising the limits of your competence is a strength, not a weakness.
This model explains when and how to seek help effectively — for the patient's sake, and for your own learning.

Every treatment decision needs a defined endpoint.
This model teaches you when to start, when to stop, and when to escalate — without guessing.

When something in the blood is low, it is raw material deficiency, production problem or loss. This model applies to albumin, haemoglobin, platelets, and clotting factors — a single framework, four clinical scenarios.

Do not memorise "reticulocytes increased." Understand why.
This model explains why immature blood cells are increased in the peripheral blood when there is peripheral cytopenia with functional bone marrow.