Improving Students’ Patient Care Management Using the Thinker’s Guide to Clinical Reasoning
Medically Compromised

The third video is a demonstration of a clinical conversation with a student planning treatment for a medically compromised patient. As the participant watches the video, they should think about the following questions. What key elements of thought emerged during the example? How were they effective?

Discussion questions:

• What key elements of thought emerged in the example?
• How were they effective?
• What assumption did the student make about the patient’s knowledge of monitoring their HbA1c?

Key elements of thought that emerged in the example are elements of purpose, clinical information, concepts, assumptions and implications. These elements of reasoning may lead to changing the patient’s therapy based on the patient’s risk indicators and the stability of the patient’s periodontium. The increasing probe depths may be significant enough to change the therapy from an adult prophylaxis to a scale and root planning. The student also took for granted the patient’s knowledge of monitoring their HbA1c level. They assumed the patient understood the meaning of an HbA1c level and the need to monitor it. Asking the student to identify the problem and important information and concepts needed to care for the patient helps them to focus on the important issues to address during the appointment. Questioning the student helps them to reason through the clinical situation and arrive at an appropriate conclusion.