Efficient Clinical Reasoning: Knowing When to Start and When to Stop

• In Event: Analyzing the Minds of Future Physicians: Topics in Professional Judgment and Reasoning

Abstract

While clinical reasoning in medicine traditionally values the ultimate goal of providing an accurate diagnosis of disease, insufficient emphasis has been placed on how students’ decisions may affect their diagnostic efficiency. In this study, we are particular interested in the decision-making process about when to start developing a diagnostic hypothesis and when to stop a diagnosis as 75 medical students solved two patient cases in a simulated intelligent environment. We compared the differences in clinical reasoning behaviours between high and low performers and explored the factors affecting the life span of incorrect hypotheses using the Cox proportional-hazards models. This study helps shift the emphasis away from a solitary focus on accuracy to one that considers the importance of diagnostic efficiency.

Authors

• Shan Li, McGill University

• Juan Zheng, McGill University

• Susanne P. Lajoie, McGill University