Response to : Clinical Diagnostic Reasoning

McColl, G. and Groves, M. (2007) Response to : Clinical Diagnostic Reasoning. New England Journal of Medicine, 356 12: 1272-1272. doi:10.1056/NEJMc063606

Author McColl, G.
Groves, M.
Title Response to : Clinical Diagnostic Reasoning
Journal name New England Journal of Medicine   Check publisher's open access policy
ISSN 1533-4406
Publication date 2007-03
Sub-type Letter to editor, brief commentary or brief communication
DOI 10.1056/NEJMc063606
Volume 356
Issue 12
Start page 1272
End page 1272
Total pages 1
Place of publication Boston, MA
Publisher Massachusetts Medical Society
Language eng
Subject 110399 Clinical Sciences not elsewhere classified
Abstract To the Editor: We agree with Bowen that clinical educators need to understand and analyze the varied diagnostic reasoning strategies applied by novices such as medical students to help them improve their performance. However, the diagnostic reasoning schema in Figure 1 of the article appears to oversimplify this process. Because of minimal clinical experience, the novice generally has poorly formed illness scripts and will often generate hypotheses using a pathophysiological, probabilistic, or rule-based representation of the problem (skills acquired during problem- or case-based learning).1,2 Such hypotheses are often more numerous, broader, and less accurate than those of experts and must be refined by the novice during the interview with the patient and during the physical examination, while the novice looks for the specific symptoms, risk factors, and signs that allow for iterative reweighting of the clinical diagnostic possibilities. We believe that acknowledgment of alternative bases for hypothesis generation and of the iterative nature of hypothesis refinement will further assist educators in improving students’ diagnostic reasoning strategies.
Q-Index Code CX
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Letter to editor, brief commentary or brief communication
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 1 times in Thomson Reuters Web of Science Article | Citations
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