Clinical cognition and diagnostic error: applications of a dual process model of reasoning
Abstract
Both systemic and individual factors contribute to missed or delayed diagnoses. Among the multiple factors that impact clinical performance of the individual, the caliber of cognition is perhaps the most relevant and deserves our attention and understanding. In the last few decades, cognitive psychologists have gained substantial insights into the processes that underlie cognition, and a new, universal model of reasoning and decision making has emerged, Dual Process Theory. The theory has immediate application to medical decision making and provides an overall schema for understanding the variety of theoretical approaches that have been taken in the past. The model has important practical applications for decision making across the multiple domains of healthcare, and may be used as a template for teaching decision theory, as well as a platform for future research. Importantly, specific operating characteristics of the model explain how diagnostic failure occurs.
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Prior work has established ample evidence of cognitive biases in high-stakes domains.
“While prior work has established ample evidence of cognitive biases in high-stakes domain [16,17,31,56,58,89]”
From Explanations Can Reduce Overreliance on AI Systems During Decision-Making (2023) · cites this paper as [16]
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- Authors
- Croskerry, P.
- Affiliations
- Dalhousie University (CA)
- Corresponding author
- Croskerry, Pat
- ORCID
- Croskerry, Pat
- Venue
- Advances in Health Sciences Education
- Published
- 2009-08-11
- Volume
- 14
- Issue
- S1
- Pages
- 27-35
- ISSN
- 1382-4996 (ISSN-L)
- 1573-1677
- OpenAlex
- W2143428226
- Cited by
- 494
- References
- 6
- Citations by year
- 2026: 46 · 2025: 19 · 2024: 23 · 2023: 25 · 2022: 37 · 2021: 44 · 2020: 28 · 2019: 37 · 2018: 38 · 2017: 30 · 2016: 26 · 2015: 32 · 2014: 33 · 2013: 24 · 2012: 22
- FWCI
- 12.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Advances in Health Sciences Education (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Keywords
- diagnostic errors, missed diagnosis, delayed diagnosis, dual-process theory, clinical reasoning, clinical decision-making, cognitive psychology, healthcare decision-making
- MeSH terms
- Cognition, Decision Making, Diagnosis, Differential, Diagnostic Errors, Humans, Models, Theoretical
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