{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T07:18:20Z","timestamp":1787815100495,"version":"build-2784847793"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004263","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado do Rio Grande do Sul","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004263","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale, Aims, and Objectives<\/jats:title>\n                    <jats:p>Clinical reasoning (CR) is fundamental to medical practice, serving to distinguish justified belief from mere opinion, achieve accurate diagnoses, and optimize treatment. However, significant uncertainty persists regarding its definition, scope, and method. This conceptual imprecision and the inherent opacity of CR\u2014when framed merely as tacit knowledge\u2014have profound theoretical and practical consequences, including the occurrence of medical errors and the loss of patient trust. This study aims to map how CR is defined and conceptually framed in the medical and health sciences literature, specifically addressing the core issues of explainability and accountability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A scoping review was conducted in strict accordance with the PRISMA\u2010ScR guidelines. A systematic literature search was performed across PubMed, Scopus, Web of Science Core Collection, and PhilPapers to identify articles discussing definitions, conceptual models, or epistemological analyses of CR. Eligible studies were screened independently by two reviewers, and data extraction and charting were synthesized descriptively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 26 studies met the inclusion criteria. The descriptive synthesis identified five major conceptual perspectives: Integrative\/Contextual (n\u2009=\u200918), which views CR as a situated process; Dual\u2010Process (n\u2009=\u200913), which distinguishes between intuitive and analytical reasoning; Expertise\/Tacit (n\u2009=\u200912), grounded in practical experience; Hypothetico\u2010Deductive (n\u2009=\u200911), centered on hypothesis formulation and testing; and Outcome\u2010Oriented (n\u2009=\u20096), focused primarily on decision\u2010making. Notably, six studies failed to provide any explicit definition of CR, further reinforcing its conceptual opacity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The literature exhibits significant diversity and a critical lack of consensus regarding what constitutes CR. The field remains epistemologically and ethically divided between the appreciation of intuition and the demand for systematization. CR inherently belongs to the \u201clogical space of reasons\u201d, requiring conceptual clarity, explainability, and public justification. Making these underlying cognitive and normative processes explicit is both an epistemological and ethical imperative to mitigate medical error, enhance the doctor\u2013patient relationship, and foster a more critical and responsible medical education.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jep.70512","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T22:17:43Z","timestamp":1782857863000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epistemological Issues in Clinical Reasoning: A Scoping Review"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2255-5173","authenticated-orcid":false,"given":"Gabriel","family":"Ferreira","sequence":"first","affiliation":[{"name":"Unisinos University S\u00e3o Leopoldo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6919-5252","authenticated-orcid":false,"given":"Marcus Vin\u00edcius Sehl","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Unisinos University S\u00e3o Leopoldo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Unisinos University S\u00e3o Leopoldo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos Dias","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Unisinos University S\u00e3o Leopoldo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo Tomasi","family":"Vargas","sequence":"additional","affiliation":[{"name":"Unisinos University S\u00e3o Leopoldo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geovana Ceres\u00e9r dos","family":"Santos","sequence":"additional","affiliation":[{"name":"Unisinos University S\u00e3o Leopoldo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Hartmann","sequence":"additional","affiliation":[{"name":"Unisinos University S\u00e3o Leopoldo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0b013e3181ace703"},{"issue":"155","key":"e_1_2_10_3_1","first-page":"1","article-title":"The Logic of Tacit Inference","volume":"41","author":"Polanyi M.","year":"1966","journal-title":"Philosophy (London, England)"},{"key":"e_1_2_10_4_1","unstructured":"M.Polanyi 2009 The Tacit Dimension. Revised ed. edi\u00e7\u00e3o University of Chicago Press."},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1609\/aimag.v38i3.2741"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1109\/ACCESS.2018.2870052"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/idpl\/ipx005"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1145\/3236009"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/2053951715622512"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/phc3.12111"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/virtualmentor.2004.6.2.fred1-0402"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-17650-0"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","unstructured":"Stewart Moira J. B.Brown et al. 2024 Patient\u2010Centered Medicine: Transforming the Clinical Method. CRC Press.","DOI":"10.1201\/9781003394679"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2010.05.004"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmqr.2022.100214"},{"key":"e_1_2_10_16_1","doi-asserted-by":"crossref","unstructured":"L.Floridi.2023 The Ethics of Artificial Intelligence: Principles Challenges and Opportunities Oxford Scholarship Online Oxford University Press https:\/\/doi.org\/10.1093\/oso\/9780198883098.001.0001.","DOI":"10.1093\/oso\/9780198883098.001.0001"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11019-023-10175-7"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00481-023-00761-x"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.36227\/techrxiv.20439192.v1"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1025969701538"},{"key":"e_1_2_10_21_1","unstructured":"J.Habermas 1985 The Theory of Communicative Action Volume 1: Reason and the Rationalization of Society. Reprint edition. Traduzido por Thomas McCarthy. Beacon Press."},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-124-2-199601150-00007"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13010-023-00129-5"},{"key":"e_1_2_10_24_1","volume-title":"Em Knowing and Acting in Medicine","author":"Baalen S.","year":"2017"},{"key":"e_1_2_10_25_1","unstructured":"R.Brandom.2002 Tales of The Mighty Dead: Historical Essays In the Metaphysics of Intentionality Harvard University Press."},{"key":"e_1_2_10_26_1","unstructured":"W.Sellars.1997 Empiricism and the Philosophy of Mind. Harvard University Press."},{"key":"e_1_2_10_27_1","doi-asserted-by":"crossref","unstructured":"E. D.Pellegrino1983 \u201cThe Healing Relationship: The Architectonics of Clinical Medicine\u201d. Em The Clinical Encounter: The Moral Fabric of the Patient\u2010Physician Relationship organizado por Earl E Shelp. Springer Netherlands https:\/\/doi.org\/10.1007\/978-94-009-7148-6_11.","DOI":"10.1007\/978-94-009-7148-6_11"}],"container-title":["Journal of Evaluation in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.70512","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jep.70512","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.70512","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T06:34:26Z","timestamp":1787812466000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jep.70512"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":26,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/jep.70512"],"URL":"https:\/\/doi.org\/10.1111\/jep.70512","archive":["Portico"],"relation":{},"ISSN":["1356-1294","1365-2753"],"issn-type":[{"value":"1356-1294","type":"print"},{"value":"1365-2753","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]},"assertion":[{"value":"2026-05-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70512"}}