Diagnostic reasoning strategies and diagnostic success

  title={Diagnostic reasoning strategies and diagnostic success},
  author={Sylvain P Coderre and Henry Mandin and Peter Harasym and G H Fick},
  journal={Medical Education},
PURPOSE Cognitive psychology research supports the notion that experts use mental frameworks or "schemes", both to organize knowledge in memory and to solve clinical problems. [] Key MethodMETHODS Think-aloud protocols were collected to determine the diagnostic reasoning used by experts and non-experts when attempting to diagnose clinical presentations in gastroenterology.
Diagnostic error and clinical reasoning
This paper focuses on the part of diagnostic errors that are driven by cognitive bias and is concerned with the application of ‘System 1’ (non‐analytic, pattern recognition) thinking.
Scripts and clinical reasoning
Context  Each clinical encounter represents an amazing series of psychological events: perceiving the features of the situation; quickly accessing relevant hypotheses; checking for signs and symptoms
Dual processing and diagnostic errors
  • G. Norman
  • Psychology
    Advances in health sciences education : theory and practice
  • 2009
Evidence from two theories in psychology relevant to diagnosis and diagnostic errors are reviewed, showing that the two processes are equally effective and instructions directed at encouraging the clinician to explicitly use both strategies can lead to consistent reduction in error rates.
Dual-process cognitive interventions to enhance diagnostic reasoning: a systematic review
While many of the studies found some effect of interventions, guided reflection interventions emerged as the most consistently successful across five studies, and cognitive forcing strategies improved accuracy and confidence judgements.
Inferences of clinical diagnostic reasoning and diagnostic error
The relationship between domain-relevant and abstract assessments of diagnostic reasoning ability
This study outlines a domain-sensitive approach to the assessment of diagnostic reasoning which uses stimuli drawn from the operational environment and measures against abstract measures of two individual components of expert reasoning in the context of power system control.
What every teacher needs to know about clinical reasoning
  • K. Eva
  • Medicine
    Medical education
  • 2005
This work focuses on teaching students to sort through a cluster of features presented by a patient and accurately assign a diagnostic label, with the development of an appropriate treatment strategy being the end goal.
Design of a Study on Suboptimal Cognitive Acts in the Diagnostic Process, the Effect on Patient Outcomes and the Infl Uence of Workload, Fatigue and Experience of Physician Diagnostic Reasoning and Diagnostic Error in Medicine
Design of a study on suboptimal cognitive acts in the diagnostic process, the effect on patient outcomes and the effect of workload, fatigue and experience of physicians is designed.
Educational strategies to promote clinical diagnostic reasoning.
  • J. Bowen
  • Education
    The New England journal of medicine
  • 2006
This article considers how doctors learn to reason in the clinical environment and recommends practical approaches that clinical teachers can use to promote the development of strong diagnostic
Reasoning processes in clinical reasoning: from the perspective of cognitive psychology
This paper reviews the reasoning processes involved in clinical reasoning from the perspective of cognitive psychology and two types of reasoning process required for critical thinking are discussed: inductive and deductive.


A Cognitive Perspective on Medical Expertise: Theory and Implications
A new theory of the development of expertise in medicine is outlined, which assumes that expertise is not so much a matter of superior reasoning skills or in-depth knowledge of pathophysiological states as it is based on cognitive structures that describe the featur.
Further evidence of the relationship between case typicality and diagnostic performance: implications for medical education
Further evidence is produced demonstrating that DDx performance is a function of a test case's typicality, which could serve as the basis for effective and efficient curricular reforms in medical education.
Education and Thinking: The Role of Knowledge.
Abstract : Psychological science is obtaining increased understanding of the nature of human thinking and problem solving. This report addresses the question of how this understanding contributes to
Medical problem‐solving: some questionable assumptions
It is concluded that a considerable amount of research on the nature of such strong methods in expert clinical reasoning is needed before any confident claims can be made regarding the use of the hypothetico‐deductive or any other method.
Cognitive psychology and medical diagnosis
The nature and acquisition of complex cognitive skills have been intensively investigated over the past 20 years. From such studies in non-medical domains it appears that experts (a) generally
Instructional Design: Implications from Cognitive Science
Introduction to cognitive science and instructional design chunking - organizing strategies frames, type one frames, type two concept mapping advance organizer metaphor, analogys and simile rehearsal
Think-aloud approaches to cognitive assessment and the articulated thoughts in simulated situations paradigm.
The articulated thoughts in simulated situations (ATSS) paradigm is a think-aloud approach to cognitive assessment that has several advantages: an unstructured production response format, on-line rather than retrospective assessment, situational specificity and control, and flexibility of situation and cognitions.
Issues in cognitive psychology: implications for professional education
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  • Computer Science
    Academic medicine : journal of the Association of American Medical Colleges
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Education and cognitive psychology have tended to pursue parallel rather than overlapping paths. Yet there is, or should be, considerable common ground, since both have major interests in learning
Using structured medical information to improve students' problem-solving performance.
The results showed that the experimental group acquired a higher ratio of diagnostic to nondiagnostic cues, mentioned the correct diagnosis sooner in their workups, and correctly diagnosed the most difficult case more often than the control group.