The Role of Biomedical Knowledge in Clinical Reasoning: Bridging the Gap between Two Theories

Department of Philosophy of Science, Institute for Humanities and Cultural Studies, Tehran, Iran


There has been a long-lasting debate on the role of biomedical knowledge in physicians’ clinical reasoning. There are two major views. The two-worlds theory assumes that biomedical knowledge and clinical knowledge are two different worlds and that biomedical knowledge is not involved in clinical reasoning of expert doctors. However, according to the knowledge encapsulation view, biomedical knowledge still has an influential role in doctors’ clinical reasoning and medical problem solving. Based on the illness script theory, it can be concluded that these two views have two different definitions for basic science. In the knowledge encapsulation theory, pathophysiology stands for basic science, while in the two-worlds theory, basic science is equal to normal body function and structure. This is because illness script theory clearly highlights the primacy of practice in medicine, and according to this theoretical framework, bridging the gap between two theories becomes possible.


  • Biomedical knowledge
  • Clinical reasoning
  • Two-worlds theory
  • Knowledge encapsulation theory
  • Illness script theory

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