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The head, bones, and tail map presenting problems, reasoning steps, added ribs for complications/prognosis and prevention, and support holistic guidance for trainees.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/exam/","Exam",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/the-holistic-approach-to-clinical-problem-using-fishbone-format-a-simple-way-for-clinical-reasoning/665401/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/the-holistic-approach-to-clinical-problem-using-fishbone-format-a-simple-way-for-clinical-reasoning/665401.png","ImageObject",300,407,{"name":42,"@type":43},"Malam Tenang","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-10-29",true,{"@type":52,"interactionType":53,"userInteractionCount":22},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What is the fishbone format in clinical reasoning teaching?","Question",{"text":62,"@type":63},"It is a structured schemata consisting of a head, six bones, and a tail, where each part represents steps in clinical reasoning for patient problem solving.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"How do the fishbone elements correspond to clinical reasoning steps?",{"text":67,"@type":63},"The head represents the presenting problem, while the first through sixth bones cover defining the problem (including basic sciences), etiology/differential diagnosis, clinical picture and examination, investigations, treatment, and complications/prognosis; the tail emphasizes prevention.",{"name":69,"@type":60,"acceptedAnswer":70},"Where can the fishbone format be used for teaching and learning?",{"text":71,"@type":63},"It can be applied in multiple teaching settings including lecture theatre, small group discussion, tutorials, skills labs, and clinical settings to guide educators and students toward integrated patient management.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},665401,1793302396,{"code":4,"msg":81,"data":82},"success",[83,87,91,94,99,104,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":92,"slug":93},70,"exam",{"id":95,"doc_module":4,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},5,"Comic",60,"comic",{"id":100,"doc_module":4,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},6,"Technology",50,"technology",{"id":105,"doc_module":4,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},7,"Healthcare",40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":95,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":33,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":22,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":105,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":79,"read_time":143},962093532863,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","| \u003Cbr>INNOVATIVE IDEAS\u003Cbr>Volume 6 Issue 3 2014 DOI:10.5959/eimj.v6i3.251 [www.eduimed.com](www.eduimed.com) |  |  |\n| --- | --- | --- |\n| The Holistic Approach to Clinical Problem Using Fishbone Format: A Simple Way for Clinical Reasoning\u003Cbr>Omar AR Bawazir\u003Cbr>Hadramout University College of medicine (HUCOM), Hadramout / Yemen, Mukalla. |  |  |\n| ARTICLE INFO\u003Cbr>Received : 23/01/2014\u003Cbr>Accepted : 07/07/2014\u003Cbr>Published : 01/09/2014\u003Cbr>KEYWORD\u003Cbr>Clinical reasoning Medical problem solving Fishbone\u003Cbr>Pattern of recognition Problem based learning Skills lab (Clinical Skills Centre)\u003Cbr>Teaching/learning Medical Education | ABSTRACT\u003Cbr>Introduction: Clinical reasoning (CR) is the cornerstone of medical curricula. It is the cognitive process of solving patient’s problem. Different teaching methods are advocated to teach clinical reasoning. Each has its advantages and disadvantages. Aim: to introduce and discuss the fishbone format as a systematic structured method to enhance teaching and learning of clinical reasoning to medical students in different teaching settings. Method: The format consists of a head, six bones and the tail. The head represents the presenting problem or complaint; the bones represent the different steps of the clinical reasoning. The first bone of defining the presenting problem is expanded to include the basic sciences. In addition we add a sixth rib for complication/prognosis and the tail is kept for the prevention. Results: The format can be used in different teaching settings such as, lecture theatre, small group discussion, tutorial, skills lab, and clinical settings. It will help preceptors to facilitate and guide teaching of clinical problem in a holistic logical sequence. It encompasses both models of clinical reasoning, pattern of recognition and the hypothetico-deductive one. Conclusion: This is a simple schemata aims to guide trainers and students to see and learn the full picture of patient management and emphasize on integration rather than isolation of clinical competence domains during teaching activities. Teachers and learners of other fields of science will find it helpful as well. |  |\n| © Medical Education Department, School of Medical Sciences, Universiti Sains Malaysia. All rights reserved. |  |  |\n| CORRESPONDING AUTHOR: Dr Omar Abdul-Rahman Bawazir, Hadramout University College of\u003Cbr>medicine (HUCOM), Hadramout / Yemen, Mukalla, P.O. Box 8927. Email: [omarbawazir@yahoo.com](omarbawazir@yahoo.com) |  |  |\n| Introduction\u003Cbr>Clinical reasoning (CR) is the cognitive process of solving patient’s problem and the cornerstone of medical curricula. Researchers have advocated many theories about this process such as the hypothetic-deductive (analytic process) and pattern recognition (non-analytic process or intuitive process) separately or in combination (1) . According to Barrows & Tamblyn (2), it consists of five steps or elements. There is no |  | optimal method to teach clinical reasoning because it depends on both situational and personal factors. Nevertheless, many attempts and strategies are posited to facilitate teaching and learning of clinical solving problems particularly at the early years of the medical schools so as to improve such skill later on (1-6) . However, neither of these strategies addresses the clinical reasoning formally and explicitly. |\n| Education in Medicine Journal (ISSN 2180-1932) © [www.eduimed.com](www.eduimed.com | e72)[ | e72](www.eduimed.com | e72) |  |  |\n\n\n| On the other hand, clerkship students have limited contact time with patients and hardly any reflection at the bedside teaching which compromises their clinical problem-solving capabilities; hence delay of introducing clinical reasoning might be the cause of poor performance of student’s medical solving problem (7).These factors urge researchers to develop and submit new thoughts and ideas to address the teaching of CR (8) . | This paper explains and discusses the fishbone format and its different elem","cbCaicsh12ybCejy","https://ap.wps.com/l/cbCaicsh12ybCejy","pdf",403901,"English","# Introduction\n## Fishbone format elements and clinical reasoning steps\n## Fishbone development and teaching settings","[{\"question\":\"What is the fishbone format in clinical reasoning teaching?\",\"answer\":\"It is a structured schemata consisting of a head, six bones, and a tail, where each part represents steps in clinical reasoning for patient problem solving.\"},{\"question\":\"How do the fishbone elements correspond to clinical reasoning steps?\",\"answer\":\"The head represents the presenting problem, while the first through sixth bones cover defining the problem (including basic sciences), etiology/differential diagnosis, clinical picture and examination, investigations, treatment, and complications/prognosis; the tail emphasizes prevention.\"},{\"question\":\"Where can the fishbone format be used for teaching and learning?\",\"answer\":\"It can be applied in multiple teaching settings including lecture theatre, small group discussion, tutorials, skills labs, and clinical settings to guide educators and students toward integrated patient management.\"}]","The Holistic Approach to Clinical Problem Using Fishbone Format - A Simple Way for Clinical Reasoning | PDF",18]