Dinâmica de desenvolvimento do raciocínio clínico e da competência diagnóstica na formação médica – sistemas 1 e 2 de raciocínio clínico

Abstract

The medical expertise is one of the main quality determinants for medical care provided to patients. It develops during the undergraduate course and also during the professional training, being subject to knowledge acquisition as well as how this knowledge is used, and is also subject to the clinical case approach. The processing of the accumulated knowledge for an accurate clinical application is called clinical reasoning, which is cate gorized by some authors in non-analytical or automatic clinical reasoning (System 1) and analytical or reflexive clinical reasoning (System 2). System 1, commonly used on routine cases, is characterized by a little or none mental effort to solve the cases, being fast and intuitive; System 2, in turn, applies to less common or more complex cases, and is prepared, aware and slow. Although both forms of clinical reasoning are equally effective to solve the cases, the medical professional should be prepared to use one or another, according to the complexity of the discussed case and to his own practical experience, in order to ensure a better diagnostic accuracy and a better approach to the patient