Challenges in the Pedagogy of Clinical Reasoning: a philosophical reframing

Clinical reasoning lies at the heart of medical practice, yet its teaching remains one of the most conceptually complex challenges in medical education. Contemporary approaches, largely informed by cognitive science, have illuminated the mental mechanisms underlying diagnosis but have simultaneously reduced reasoning to an individual, decontextualized act of information processing. This reduction has led to a subtle yet pervasive dehumanization of clinical reasoning, obscuring its social, embodied, and interpretive dimensions. This paper argues that a comprehensive understanding of clinical reasoning requires a philosophical reframing that integrates insights from the philosophy of science, medicine, and technology, i.e. TRI-P model. In this sense, Medicine is best understood as a scientific practice realized through the mediation of technology, yet always oriented toward its ultimate telos: the care and healing of the patient. Through this synthesis, the study shows that reasoning in medicine is not a neutral cognitive operation but an interpretive, dialogical, and technologically mediated form of human understanding. Accordingly, a rehumanized pedagogy—grounded in epistemic pluralism, dialogical humanism, and critical technological literacy—is essential for cultivating responsible clinical judgment. From this perspective, clinical reasoning cannot be captured by cognitive models alone but must be reframed as phronesis: a form of practical wisdom enacted in moral and interpretive contexts. Drawing on Gadamer’s hermeneutic philosophy and Kenneth Sharpe’s conception of phronetic practice, the paper situates clinical reasoning as an embodied, dialogical, and ethically responsive activity. It concludes that medical education should nurture reflective judgment and moral discernment rather than mere analytical accuracy.

Keywords:

clinical reasoning , Pedagogy , philosophy of medicine , philosophy of science , philosophy of technology