Clinical Intuition: A Skill Every Clinician Needs to Master

I often find I can't turn off my clinical side. Recently, I had to take my three-year-old dog to the vet for decreased appetite. I watched the vet circle his hands around her abdomen to palpate her internal organs. I watched him pause... “Did he just hesitate as he palpated her? Did he feel something abnormal?" I remember thinking this to myself. Questioning his hesitation. But moments later, he completed his exam and said she was normal. I didn’t question him, and he said she looked great. He was a seasoned vet. He should know what he’s doing, right?

Turns out, I should have questioned him. He did feel something. Things were not normal, and her spleen was actually four times its normal size! He just questioned his physical exam and thought it wasn't possible in such a healthy-looking three-year-old dog. Darn! I should have listened to my gut and questioned whether he felt something. I didn’t listen to my intuition or observation skills. 

Trust Your Clinical Instincts

As healthcare professionals, our clinical intuition, along with our assessment skills, can be a powerful tool. Our training, experience, and pattern recognition can help us to sense when something isn't right, even before lab results or imaging confirm it. There’s more to it, though. 

The Science Behind Clinical Intuition

Research supports the role of intuition in clinical decision-making. Studies suggest that experienced clinicians often make faster, more accurate assessments based on subconscious pattern recognition. This doesn’t mean we abandon evidence-based practice. It means we acknowledge that intuition is a refined skill developed through exposure and experience.

When Instincts Are Overridden

How many times have you felt something was "off" but hesitated to speak up? Here are common reasons clinicians ignore their intuition:

• Fear of being wrong: No one wants to appear uncertain or alarmist.
• Confidence in authority: Trusting a senior colleague or test result over a gut feeling.
• Cognitive biases: Assumptions based on past experiences that may not apply to the current case.

Real-World Clinical Intuition in Action

One case stands out to me: A patient had been coming into the practice for years with a diagnosis of TMJ. I was new to him, and he was asking for the same old treatment—pain meds. I dug a little deeper into his history, and one phrase he used caused me to pause. "It's a shocky feeling in my ear." I remember stopping, looking at him with a puzzled expression, and thinking, "Shocky does not sound like TMJ." I asked if he'd ever had HSV, and he had.

A little further digging, and, on a hunch, I asked if he'd be willing to trial some Acyclovir. He was. Sure enough, it worked. His ear pain was not TMJ but recurrent herpes. He was forever grateful to me for listening to my gut.

Another time, I saw a patient who had been repeatedly diagnosed with anxiety and prescribed medications accordingly. Something about their vague complaints, an uneasiness in their chest, a sense of "impending doom," made me reconsider. I ran a D-dimer, and sure enough, they had a pulmonary embolism. That gut feeling saved a life.

Developing and Honing Clinical Intuition

If intuition is a skill, it can be strengthened. Here’s how:

1. Reflect on past experiences – Maybe even write down cases where your instincts were correct (or where you wish you had acted differently).
2. Mentor and discuss – Engage in case discussions with peers, questioning each step of decision-making.
3. Stay up to date – Knowledge fuels intuition. The more you know, the sharper your subconscious pattern recognition becomes.
4. Trust, but verify – Follow up on cases where you had a strong feeling. Did the outcome validate your instinct?

Takeaways for NPs, NP Students, and Clinicians

• Your gut feeling is not just a “hunch”—it’s an accumulation of training, experience, and knowledge.
• Pause when something doesn’t feel right. Reassess, ask questions, and advocate for a deeper look.
• Support each other. Encourage discussions where intuition played a role in decision-making, whether right or wrong.

Clinical intuition is not a replacement for science; it’s a complement to it. As healthcare professionals, we owe it to our patients to balance data with instinct, ensuring the best possible outcomes.

While Kira’s journey has come to a close, the lesson she left me with lives on: Trust your training. Trust your eyes. And above all, trust your gut. It just might be speaking the truth before anyone else can see it.

Have you ever had a gut feeling that turned out to be right? Share your experience!


About the Author

Lynn McComas is the CEO and founder of PreceptorLink and a recognized expert in precepting nurse practitioners and advanced practice provider students. With over two decades in primary care, Lynn has served as a coach, advisor, mentor, and preceptor for countless healthcare professionals, including NPs, nurses, and medical assistants. She co-founded a successful skills and procedures business and speaks nationwide on NP-related issues.

Lynn is also a regular contributor on LinkedIn, KevinMD, Facebook, YouTube, Instagram @preceptorlink, X @LynnMcComas, and her blog, where she addresses the growing NP and PA professions and the urgent need for preceptor sites. Her unique perspective, shaped by her business, clinical, and educational experiences, positions her as a key voice in tackling preceptor shortages. Lynn is committed to driving change—through a paradigm shift in NP education, reducing barriers, offering preceptor incentives, and advocating for reforms within the profession.​