Enhancing the "What" and "Why" of the Pharmacists' Patient Care Process With the "How" of Clinical Reasoning

Objectives. Clinical reasoning is integral to the provision of patient-centered care as outlined in the Pharmacists' Patient Care Process (PPCP). However, the PPCP was not created to foster clinical reasoning in student pharmacists and cannot be the sole tool used to characterize or cultivate these skills. This article describes elements of clinical reasoning, the relationship between clinical reasoning and PPCP, and concepts from the clinical reasoning literature that should inform the teaching of clinical reasoning skills.Findings. Key elements of the PPCP were identified in clinical reasoning definitions, but differences emerged. The literature supports clinical reasoning as a bidirectional, fluid process that is highly collaborative. Effective clinical reasoning requires multiple types of "thinking," interaction with others and the environment, self-assessment, and a tolerance for nuance or ambiguity. Teaching strategies can be used in the didactic and experiential setting to target the cognitive and contextual factors associated with clinical reasoning.Summary. Educators should consult the literature to enhance our understanding of clinical reasoning in seeking to teach, model, and foster these skills in our students. Future scholarship should include the development of models to support clinical reasoning within the profession of pharmacy, adoption and experimentation with clinical reasoning teaching techniques, and valuation of the utility of various assessment tools and processes.

Complex Thinking and Sustainable Social Development: Validity and Reliability of the COMPLEX-21 Scale

Thinking skills are essential to achieve sustainable social development. Nonetheless, there is no specific instrument that assesses all of these skills as a whole. The present study aimed to design and validate a scale to assess complex thinking skills in adult people. A scale of 22 items assessing the following aspects: analysis and problem solving, critical analysis, metacognition, systemic analysis, and creativity, in five levels, was created. This scale was validated in 626 university students from Peru. In total, 16 experts in the field helped to determine the content validity of the scale (Aiken’s V value higher than 0.8). The confirmatory factor analysis allowed the evaluation of the structure of the five factors theoretically proposed and the goodness of fit indexes was satisfactory. An item was eliminated during the process and the scale resulted in 21 items. The composite reliability for the different factors was ranged between 0.794 and 0.867. The invariance between genders was also checked and the concurrent validity was proved. The study concludes that the content validity, construct validity, concurrent validity, and composite reliability levels of the COMPLEX-21 scale are appropriate.