Veterinary Clinical Reasoning through the Lens of Situativity Theory

Clinical decision-making in veterinary medicine is a constant challenge for practitioners. Navigating the information-rich veterinary clinical encounter, from investigation to diagnosis to management, adapting to the needs of all stakeholders in the process, is a difficult skill to practice and teach. We are often our own most severe critics and aim for ‘gold standard’ patient care. But does ‘gold standard’ exist? How can we account for the multiple and diverse contextual factors that affect patient outcomes? Situativity theory, when applied to human medicine, provides a useful lens through which to view clinical reasoning and the complex interactions that take place between the clinician, the patient and the environmental factors in the clinical encounter. Applied to veterinary medicine, it allows for the identification and interpretation of a fourth dimension – the owner, or person responsible for the care of the animal. Awareness of these complex interactions, this shared responsibility with the owner and how this impacts metacognition, is crucial to rationalising what we can feasibly achieve in the clinical encounter and the delivery of contextualised care.