A Versus B: Why Clinical Reasoning, Not Your Master's, Separates Practitioners

OldBull Performance · Dr Jason Weber

You're standing over an athlete on a Tuesday morning with two options in front of you. A or B. You pick B. Nobody in the building asks you why.

That's the gap. Not the degree, not the hours, not the content you've consumed. The way our industry is headed, fewer and fewer early and mid-career professionals have to defend their clinical reasoning. Maybe you made a mistake (we all have) or maybe you haven't. The value in discussing how you arrived at a decision is critical to developing sustainable practice. The challenge is you need to account for a decision out loud, with someone standing next to you who knows more than you do. It works in every environment from medicine to Tier-1 tactical operators.

I don't have a problem with the education most have. Everyone goes undergrad, then everyone gets squeezed into a master's program of varying quality, and those programs do what they do. That's fine as far as it goes. It just isn't enough, and it was never going to be. Your master's degree from whatever university is not the thing that differentiates you.

What differentiates you is whether anyone has ever asked you why you chose B.

So, who are you learning off in the real world? Every practitioner now, more than ever, needs strong mentors. And I don't mean someone you did work experience with for five minutes. I mean someone you've spent genuine time with. Talked through issues with. Been challenged by, and challenged back, and debated with. Someone you've stood in front of an athlete with, where one of you says: what are you seeing? And the other one says: here's what I'm seeing.

That's clinical reasoning, and it is vastly overlooked in most education models, specifically master's degrees and association qualifications. How did you come to that decision? What were the signals you were looking at? What made you choose A versus B? Most mentoring never gets past watch me. Watching a good practitioner do the right thing teaches you the thing. It doesn't teach you the reasoning underneath it, and the reasoning is the only part that travels to the next athlete, the next sport, the next job.

Your first mentor may not be vastly experienced. Start there anyway. But keep pushing up the chain. No one just gives genuine mentoring away, you're going to have to go and pursue it. Here's a tip... when you interview for a job, you conduct your own interview. Find out what they know and what they can teach you. Ask if they have a mentoring or development curriculum.

Then the second part is your community.

You need peers you can throw ideas at. Question things. Propose things. Say: I've got this problem, what do you think? You need somewhere you can put your reasoning into words and have it come back at you. As they get stronger, you get stronger. You help them, they help you.

And it has to be a group, not one person. When one person tells you you're wrong, you get to decide to ignore them. When the room says it, you don't. A great coach said to me once: listen to the feedback, take the feedback. If the mob is saying you're wrong, then it is probably correct. If you don't think so, argue! The finest example of technical mastery is the ability to verbally (and to an extent physically) demonstrate your logic is correct to a group who thinks you are wrong.

Two years of a master's. Five minutes of work experience. And not one person who has ever asked you why you picked B.

Find the one who asks why. Push up the chain when you've outgrown them. Build the group. Say your reasoning out loud to people who will tell you when it's wrong. Then go and stand in front of the athlete and do it again.