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The social construction of clinical knowledge – the context of culture and discourse. Commentary on Tonelli (2006), Integrating evidence into clinical practice: an alternative to evidence‐based approaches. Journal of Evaluation in Clinical Practice 12, 248–256
Author(s) -
Malterud Kirsti
Publication year - 2006
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2006.00591.x
Subject(s) - context (archaeology) , citation , clinical practice , library science , health care , section (typography) , unit (ring theory) , medicine , psychology , medical education , sociology , family medicine , political science , computer science , history , mathematics education , law , archaeology , operating system
Clinical knowledge evolves from interpretative action and interaction – matters involving human interaction, mind and experiences. My own attention has so far primarily been drawn to the microlevel of evidence construction in the encounter between doctor and patient. I have previously discussed clinical reasoning as multilayered processes of social interaction and human interpretation of bodily signs, for the purpose of coming to an understanding with the patient about what is wrong and what is to be done (Malterud 2001; Malterud 2002). On this level, the epistemological complexity of understanding and decision making first and foremosts demonstrates the inadequacy of a confined biomedical approach, where only questions and phenomena that can be controlled, measured and counted are regarded as valid.