Abstract:

During the academic training process, in the health area, the development of students' clinical reasoning is essential, because the health professional depends on this reasoning for making decisions in front of the patient. This is a process acquired, perfected and adapted by the health professional from time to time to the reality in which it is inserted. Linked to the clinical reasoning is critical thinking, which considers different factors, evidences and contexts to decide what to do or believe, giving the professional the necessary security in the making of decisions. A way to encourage critical reasoning and critical thought is the use of clinical cases, as it stimulates the discussion and resolution of the proposed problem, promoting the formulation of diagnostic hypotheses, directing the complementary exams, through detailed data collection, involving information from various sources, for solving a problem. Considering this perspective, standardizing the way to structure a clinical case is important for the teaching-learning process, besides facilitating its construction by the professor; the student would have a more coherent text to develop their clinical reasoning. In order for the clinical case to be constructed and standardizing, should keep in mind some pertinent questions. Who is the individual to be approached in the case? Where is the individual inserted? Who are the agents? How did the individual get the problem situation? What aspects are important to the approach? These guiding questions will assist the professor in the elaboration of a clinical case that is comprehensible and relevant to clinical reasoning. There are several models and strategies that to use to teach clinical reasoning, such as exercise resolution, reading, debate, seminars, discussion, and others. All of these tools are valid. However, there is an instrument, which uses annotations collected from medical records or informal notes, called the acronym IDEA. This is an ideal resource and easy to reproduce, making use of accessible information and facilitating the organization of the essential elements in a clinical case. The IDEA consists of four elements. Interpretive summary where the main findings of the history, physical examination and complementary are allocated. Differential diagnosis is understood as the main hypothesis of the case. Explanation of reasoning is the reason for choosing the diagnosis in the previous item and the information that supports it. Alternative diagnosis is the differential diagnosis. The sub-items that should be in this item are: Identification, Main Complaint, History of Current Illness, description of environment, contextualization of, a complete and comprehensible story in a succinct way addressing the essential elements for clinical reasoning. In view of this problem, it is suggested that the acronym IDEA can be an important model of clinical case structure, which makes possible a more complete and chronological sequence of clinical, critical and reflexive thought, necessary requisites for learning in the health area.

Keywords:

Problem-based Learning, Educational Technology, Health.