The clinical reasoning characteristics of diagnostic experts

Groves, M., O'Rourke, P., & Alexander, Heather (2003) The clinical reasoning characteristics of diagnostic experts. Medical Teacher, 25(3), pp. 308-313.

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Abstract

The aim of this study was to identify and describe the clinical reasoning characteristics of diagnostic experts. A group of 21 experienced general practitioners were asked to complete the Diagnostic Thinking Inventory (DTI) and a set of 10 clinical reasoning problems (CRPs) to evaluate their clinical reasoning. Both the DTI and the CRPs were scored, and the CRP response patterns of each GP examined in terms of the number and type of errors contained in them. Analysis of these data showed that six GPs were able to reach the correct diagnosis using significantly less clinical information than their colleagues. These GPs also made significantly fewer interpretation errors but scored lower on both the DTI and the CRPs. Additionally, this analysis showed that more than 20% of misdiagnoses occurred despite no errors being made in the identification and interpretation of relevant clinical information. These results indicate that these six GPs diagnose efficiently, effectively and accurately using relatively few clinical data and can therefore be classified as diagnostic experts. They also indicate that a major cause of misdiagnoses is failure to properly integrate clinical data. We suggest that increased emphasis on this step in the reasoning process should prove beneficial to the development of clinical reasoning skill in undergraduate medical students.

Impact and interest:

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ID Code: 95201
Item Type: Journal Article
Refereed: Yes
Keywords: article, clinical practice, controlled study, data analysis, diagnosis, diagnostic accuracy, diagnostic error, evaluation, general practitioner, human, medical decision making, medical expert, medical information, professional practice, scoring system, skill, Adult, Australia, Decision Support Techniques, Diagnostic Errors, Humans, Logic, Physicians, Family, Questionnaires, Thinking
DOI: 10.1080/01421590306814
ISSN: 0142-159X
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Copyright Owner: Copyright 2003 Medical Teacher
Deposited On: 29 Apr 2016 01:46
Last Modified: 29 Apr 2016 01:46

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