Exploring Rhizomatic Thinking in Clinical Reasoning

Abstract

Mental models of health and illness used during clinical practice are predominantly based on reductionism and mechanistic explanations. Systems thinking offers a more holistic conceptualization by viewing the human body to consist of several closely linked organ systems, constantly interacting with each other and embedded in, and ‘open’ to, the external environment. Operationalizing this view to clinical reasoning at the bedside requires networked thinking, concept maps, and tools such as Clinical Reasoning Map (CRM). These are diagrammatic methods that explicitly depict the links across multiple nodes such as diseases, disorders, clinical features, and pathogenetic mechanisms. Systems thinking could be extended to rhizomatic thinking where a metaphor of the rhizome is applied to view complex clinical scenarios. It helps to deepen the understanding of the interconnected nature of cases and the multiple pathogenic pathways, generate differential diagnoses, and predict future prognostic pathways. In the case of planning and providing care, rhizomatic thinking will shift emphasis from a biomedical model to include the social systems, ecosystems, and the built environment. It adds to the growing corpus of novel complex thinking such as whole systems thinking and synergetics, described by Edgar Morin. It is a novel approach to clinical practice, clinical reasoning and its pedagogy.