I would really like to think that the clinical reasoning process is simply a matter of weighing evidence, applying the principles of logic and deductive reasoning, and making sound decisions based on the evidence. Sounds pretty simple, doesn’t it?

But I know better. It’s not just about evidence. It never has been. If it was, there would never be any emotionally-charged debates on an assessment method or a treatment technique.

Clinical reasoning involves beliefs – whether we want to believe so or not - and beliefs can have a significant disparity with scientific evidence.

We're all driven by our belief systems. We select data to support our beliefs. We impose our own biases on the world around us. Beliefs are not necessarily lies, but they aren’t necessarily the one-and-only “truth” either. Beliefs can trump evidence, sad as that may sound.

But if we know how we function, and we are aware of our thought processes, then we can have greater insight into all the factors that truly impact clinical reasoning. We can become better clinicians and, better yet, better people. With this in mind, I propose a new model for understanding the perceptual factors that influence the clinical reasoning process.

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When you are an athlete at the top of your game, your skill and talent tend to polarize fans and fellow athletes. They either love you - because you are such a phenomenal talent - or they hate you - because they are so fed up with you being at the top of your game all the time. This love/hate relationship tends to, in hindsight, remind us of how great an impact the athlete had on the game they dominated. Athletes in this category tend to inspire the passions of fans -one way or another.

In Formula One, we've seen this phenomenon a number of times. Michael Schumacher is a great example. Perhaps one of the greatest, if not THE greatest, driver that Formula One has ever seen. I was always able to appreciate his raw talent and skill - but it would always drive me crazy the way he dominated the sport. He had a very passionate following, and when he retired, everyone knew (fan or otherwise) that the sport was losing something special. We'd been witness to something special - and we could all look back and be thankful for it.

It could be Micheal Schumacher or Michael Johnson or Michael Jordan - there is something very special about watching an athlete compete at the highest level as they set new standards for their sport.

Prior to the Schumacher era, we'd seen another driver of comparable ability - and his name was Ayrton Senna .

May 1, 1994 stands out as a tragic day in Formula One, a sad personal memory for me, and I would be remiss if I didn't mention it on this day.

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Periodization has become the Holy Grail of sport training. Don’t all the best athletes and coaches utilize different phases of training at different times of the year?

The concept, in theory, makes great sense. Training should be built around the human body’s normal mechanisms of training adaptation and recovery. Training should be designed in order to optimize gains in performance while minimizing the risk of injury.

But the traditional application of periodization is lacking. As many other issues in sport training, it has a good basis in physiology, but incomplete interpretation and application. So is periodization hurting your training plan? And if so, what can we do to optimize it?

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I was filling up the car the other day, and I had one of those moments of clarity. It was a brief flashback to my childhood. Admittedly, the gas station is not a common place to trigger memories, but in some ways, it was very appropriate and telling.

One thing that suddenly stood out in my mind was how so much of life has changed - even simple things like gas stations. Do you remember full servivce gas stations? When I was a child, my parents and I did a lot of travel by car. We had many long driving trips - to Florida, the deep south, and to countless auto races in the summertime. A fine example was all the times we drove through upstate New York on the way to Watkins Glen and the Finger Lakes . I can remember stopping at the gas station ... at times, they were called "service stations" - and an attendant would spring into action, walking up to the driver's side, asking my father what gas he would like and if he wanted him to check under the hood. It was the de-facto standard of summertime driving trips for us, and we certainly drove through our share of "Smalltown, USA" on our travels "off the beaten path". 

Funny how these things are so vivid in my mind.

What amazes me now ...

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