Abstract
Diagnostic reasoning and medical decision making have been focal areas of research in the fields of medical education, cognition, and artificial intelligence in medicine. Drawing on several decades worth of research, we propose an integrated summary of prior research on diagnostic reasoning and decision making-in terms of both historical development and theoretical shifts. We also characterize the changes in research and theory resulting from the incorporation and adoption of health information technology in the clinical work place. In this paper, we differentiate between the various forms of diagnostic reasoning and trace the evolution of the various models of reasoning, including knowledge-based, exemplar-based, and visual strategies. We also discuss the effect of clinical expertise on reasoning processes. Within the medical decision-making research, we delineate the various approaches highlighting decision-making errors that arise due to the nature of heuristics and biases and other factors. Although there has been significant progress in our understanding, there is still a need for greater theoretical integration of disparate empirical phenomena. Specifically, there is a need to reconcile the various characterizations of reasoning and to evaluate the similarity and differences in the context of current health care practice. Finally, we discuss the role of human factors research in the study of clinical environments and also in relation to devising approaches and methodologies for understanding, evaluating, and supporting the diagnostic reasoning and decision processes.
Original language | English (US) |
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Pages (from-to) | 149-190 |
Number of pages | 42 |
Journal | Reviews of Human Factors and Ergonomics |
Volume | 8 |
Issue number | 1 |
DOIs | |
State | Published - Oct 2013 |
Keywords
- diagnostic reasoning
- expertise
- heuristic and biases
- knowledge-based solution strategies
- medical decision making
- naturalistic decision making
- technology-mediated cognition
ASJC Scopus subject areas
- Human Factors and Ergonomics
- Public Health, Environmental and Occupational Health