Hypothesis Generation and the Coordination of Theory and Evidence in Novice Diagnostic Reasoning

José F. Arocha, Vimla Patel, Yogesh C. Patel

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

This study investigates hypothesis generation and evaluation in clinical problem solving by medical trainees. The study focuses on 1) directionality of reasoning and 2) use of confir mation and disconfirmation strategies in generating and evaluating hypotheses. Two clinical problems were divided into segments of information containing presenting complaint, past history, and physical examination. The initial information indicated a typical myocardial infarct but subsequent information contradicted it. The results showed that the participating students predominantly used forward reasoning and confirmation strategies. When faced with con tradictory evidence: 1) second-year students ignored cues in the problem or reinterpreted them to fit the hypothesis; 2) third-year students generated concurrent hypotheses to account for different sets of data; and 3) fourth-year students generated several initial hypotheses and subsequently narrowed the hypothesis space by generating a single coherent diagnostic explanation. The results are discussed in terms of coordination of clinical evidence and its relationship to scientific reasoning. Key words: hypothesis generation; diagnostic reasoning; novice strategies; medical problem solving.

Original languageEnglish (US)
Pages (from-to)198-211
Number of pages14
JournalMedical Decision Making
Volume13
Issue number3
DOIs
StatePublished - Jan 1 1993
Externally publishedYes

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Students
Physical Examination
Cues
Myocardial Infarction
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ASJC Scopus subject areas

  • Health Policy

Cite this

Hypothesis Generation and the Coordination of Theory and Evidence in Novice Diagnostic Reasoning. / Arocha, José F.; Patel, Vimla; Patel, Yogesh C.

In: Medical Decision Making, Vol. 13, No. 3, 01.01.1993, p. 198-211.

Research output: Contribution to journalArticle

Arocha, José F. ; Patel, Vimla ; Patel, Yogesh C. / Hypothesis Generation and the Coordination of Theory and Evidence in Novice Diagnostic Reasoning. In: Medical Decision Making. 1993 ; Vol. 13, No. 3. pp. 198-211.
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