SOME COGNITIVE COMPONENTS OF THE DIAGNOSTIC THINKING PROCESS

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Abstract
Summary. The importance of including the development of clinical problem‐solving skills as an aim of undergraduate medical education is increasingly stressed. However, in order to facilitate such skills, they must themselves be known. The model of hypothesis generation and testing provides only a generalised description. The present study identifies 14 separate cognitive components of the diagnostic thinking process. No statistically significant differences are found between groups of final year clinical medical students, house officers and post‐MRCP registrars in incidence of these, although it is indicated that the relative use of such thinking processes by individuals or from case to case might differ. Such individual differences might derive from varying degrees of clinical experience. The range of diagnostic thinking processes, however, is characteristic of all mature adult cognition. Medical education, therefore, need not teach these processes as such. In addition, it cannot be prescriptive but must facilitate in the student self‐awareness and self‐monitoring skills for the entire range of potential thinking processes, some subset of which might be employed at any one time.

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