Focusing and defocusing. A proposal
DOI:
https://doi.org/10.30860/0124Keywords:
Clinical reasoning, Lens, Metacognition, Language, Primary CareAbstract
Professionals who apply a generalist approach carry out highly complex cognitive and affective work with each patient. This cognitive and affective work could be compared to the use and selection of a lens or objective to take a photograph of a person: some lenses highlight biomedical aspects, while others help to understand the personal or biographical, psychological, social and environmental context. In this article, we describe the action of focusing and defocusing as a specific function of clinical reasoning in generalist practice, and how the person and their narrative serve as a “grounding” for this affective-cognitive work. Longitudinality and bonding, the organization of the team in which one works, and the commitment of the professional influence the process. This cognitive and affective work developed over the time can generate fatigue. Descriptive language has a relevant role in generalist clinical reasoning. Having someone to guide the reflection in practice can facilitate learning to use this function.
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