Beyond thinking fast and slow: Implications of a transtheoretical model of clinical reasoning and error on teaching, assessment, and research
Abstract
From dual process to a family of theories known collectively as situativity, both micro and macro theories of cognition inform our current understanding of clinical reasoning (CR) and error. CR is a complex process that occurs in a complex environment, and a nuanced, expansive, integrated model of these theories is necessary to fully understand how CR is performed in the present day and in the future. In this perspective, we present these individual theories along with figures and descriptive cases for purposes of comparison before exploring the implications of a transtheoretical model of these theories for teaching, assessment, and research in CR and error.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Comprehensive models of cognition, such as the transtheoretical model, incorporate external factors, including interactions with team members or databases, which could be implemented for LLMs with Retrieval Augmented Generation.
“Comprehensive models of cognition, such as the transtheoretical model31 incorporate external factors, including interactions with team members or databases, which could be implemented for LLMs with Retrieval Augmented Generation31.”
From Large Language Models lack essential metacognition for reliable medical reasoning (2025) · cites this paper as [31]
Cites
The Ecological Approach to Visual Perception: Classic Edition
Gibson, J. J. (2014) · doi:10.4324/9781315740218 · Cited by 12,132 · see citing works
Kirschner, P. A., Sweller, J., & Clark, R. E. (2006) · Educational Psychologist · doi:10.1207/s15326985ep4102_1 · Cited by 6,887 · cited 1× · see citing works
“Fundamental principles and foundational concepts (e.g. anatomy, physiology, biochemistry, etc) must be explicity taught Kirschner et al. (2006).”
Dual-Processing Accounts of Reasoning, Judgment, and Social Cognition
Evans, J. S. B. T. (2008) · Annual Review of Psychology · doi:10.1146/annurev.psych.59.103006.093629 · Cited by 5,137 · see citing works
Individual differences in reasoning: Implications for the rationality debate?
Stanovich, K. E., & West, R. F. (2000) · Behavioral and Brain Sciences · doi:10.1017/s0140525x00003435 · Cited by 4,255 · see citing works
Ericsson, K. A. (2004) · Academic Medicine · doi:10.1097/00001888-200410001-00022 · Cited by 2,988 · cited 2× · see citing works
“Another critical aspect of expertise development involves the formation of robust retrieval networks, that facilitate rapid access to scripts when needed by working memory (Ericsson 2004; Graber et al. 2005).”
Smith, E. R., & DeCoster, J. (2000) · Personality and Social Psychology Review · doi:10.1207/s15327957pspr0402_01 · Cited by 1,776 · see citing works
Embodiment and Cognitive Science
Gibbs, R. W. (2005) · Cambridge University Press eBooks · doi:10.1017/cbo9780511805844 · Cited by 1,726 · see citing works
The Importance of Cognitive Errors in Diagnosis and Strategies to Minimize Them
Croskerry, P. (2003) · Academic Medicine · doi:10.1097/00001888-200308000-00003 · Cited by 1,675 · see citing works
Diagnostic error in internal medicine
Graber, M. L., Franklin, N., & Gordon, R. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.13.1493 · Cited by 1,549 · see citing works
Cognitive load theory in health professional education: design principles and strategies
Van Merriënboer, J. J. G., & Sweller, J. (2010) · Medical Education · doi:10.1111/j.1365-2923.2009.03498.x · Cited by 1,511 · cited 1× · see citing works
“” This approach places greater focus on the transition from teaching learners in the classroom to teaching in authentic and simulated clinical environments (Van Merri € enboer and Sweller 2010; Mutter et al. 2020; Soh et al. 2020).”
Improving Diagnosis in Health Care
Committee on Diagnostic Error in Health Care, Board on Health Care Services, Institute of Medicine, & The National Academies of Sciences, E. (2015) · doi:10.17226/21794 · Cited by 1,376 · see citing works
Theoretical Foundations of Learning Environments
Land, S. M., Jonassen, D. H., & Jonassen, D. H. (2014) · Routledge eBooks · doi:10.4324/9781410603203 · Cited by 1,364 · see citing works
A Universal Model of Diagnostic Reasoning
Croskerry, P. (2009) · Academic Medicine · doi:10.1097/acm.0b013e3181ace703 · Cited by 1,016 · see citing works
What every teacher needs to know about clinical reasoning
Eva, K. W. (2004) · Medical Education · doi:10.1111/j.1365-2929.2004.01972.x · Cited by 939 · see citing works
Programmatic assessment: From assessment of learning to assessment for learning
Schuwirth, L. W. T., & Van der Vleuten, C. P. M. (2011) · Medical Teacher · doi:10.3109/0142159x.2011.565828 · Cited by 902 · see citing works
A model for programmatic assessment fit for purpose.
van der Vleuten, C. P. M., Schuwirth, L. W. T., Driessen, E. W., Dijkstra, J., Tigelaar, D., Baartman, L. K. J., & van Tartwijk, J. (2012) · Medical Teacher · doi:10.3109/0142159x.2012.652239 · Cited by 892 · see citing works
The Cambridge handbook of situated cognition
Wilson, R. A., & Clark, A. (2008) · Cited by 761 · see citing works
The Cambridge Handbook of Situated Cognition
(2001) · Cambridge University Press eBooks · doi:10.1017/cbo9780511816826 · Cited by 648 · see citing works
Cognitive debiasing 1: origins of bias and theory of debiasing
Croskerry, P., Singhal, G., & Mamede, S. (2013) · BMJ Quality & Safety · doi:10.1136/bmjqs-2012-001712 · Cited by 605 · see citing works
Norman, G. R., Monteiro, S. D., Sherbino, J., Ilgen, J. S., Schmidt, H. G., & Mamede, S. (2017) · Academic Medicine · doi:10.1097/acm.0000000000001421 · Cited by 594 · see citing works
Diagnostic error and clinical reasoning
Norman, G. R., & Eva, K. W. (2009) · Medical Education · doi:10.1111/j.1365-2923.2009.03507.x · Cited by 500 · see citing works
Clinical cognition and diagnostic error: applications of a dual process model of reasoning
Croskerry, P. (2009) · Advances in Health Sciences Education · doi:10.1007/s10459-009-9182-2 · Cited by 494 · see citing works
Challenges and opportunities facing medical education.
Densen, P. (2011) · PubMed Central · Cited by 484 · see citing works
Teaching Clinical Reasoning: Case-Based and Coached
Kassirer, J. P. (2010) · Academic Medicine · doi:10.1097/acm.0b013e3181d5dd0d · Cited by 453 · see citing works
Cognitive interventions to reduce diagnostic error: a narrative review
Graber, M. L., KISSAM, S. M., Payne, V. L., Meyer, A. N. D., Sorensen, A. V., Lenfestey, N. F., Tant, E. M., Henriksen, K., LaBresh, K. A., & Singh, H. (2012) · BMJ Quality & Safety · doi:10.1136/bmjqs-2011-000149 · Cited by 448 · see citing works
Scripts and Medical Diagnostic Knowledge
Charlin, B., Tardif, J., & Boshuizen, H. P. A. (2000) · Academic Medicine · doi:10.1097/00001888-200002000-00020 · Cited by 445 · see citing works
Cognitive forcing strategies in clinical decisionmaking
Croskerry, P. (2003) · Annals of Emergency Medicine · doi:10.1067/mem.2003.22 · Cited by 440 · see citing works
Cognitive debiasing 2: impediments to and strategies for change
Croskerry, P., Singhal, G., & Mamede, S. (2013) · BMJ Quality & Safety · doi:10.1136/bmjqs-2012-001713 · Cited by 419 · see citing works
Durning, S. J., & Artino, A. R. (2011) · Medical Teacher · doi:10.3109/0142159x.2011.550965 · Cited by 399 · see citing works
Self-citationMamede, S., van Gog, T., van den Berge, K., Rikers, R. M. J. P., van Saase, J. L. C. M., van Guldener, C., & Schmidt, H. G. (2010) · JAMA · doi:10.1001/jama.2010.1276 · Cited by 374 · see citing works
Checklists to Reduce Diagnostic Errors
Ely, J. W., Graber, M. L., & Croskerry, P. (2011) · Academic Medicine · doi:10.1097/acm.0b013e31820824cd · Cited by 366 · see citing works
Clinical Reasoning Assessment Methods: A Scoping Review and Practical Guidance
Daniel, M. M., Rencic, J. J., Durning, S. J., Holmboe, E. S., Santen, S. A., Lang, V. J., Ratcliffe, T. A., Gordon, D., Heist, B. S., Lubarsky, S., et al. (2019) · Academic Medicine · doi:10.1097/acm.0000000000002618 · Cited by 358 · see citing works
Self-citationThe structure of reflective practice in medicine
Mamede, S., & Schmidt, H. G. (2004) · Medical Education · doi:10.1111/j.1365-2929.2004.01917.x · Cited by 345 · see citing works
How to improve the teaching of clinical reasoning: a narrative review and a proposal
Schmidt, H. G., & Mamede, S. (2015) · Medical Education · doi:10.1111/medu.12775 · Cited by 308 · see citing works
Evans, J. S. B. T. (2007) · Psychology Press eBooks · doi:10.4324/9780203947487 · Cited by 279 · see citing works
Dual processing and diagnostic errors
Norman, G. R. (2009) · Advances in Health Sciences Education · doi:10.1007/s10459-009-9179-x · Cited by 252 · see citing works
Exploring the Etiology of Content Specificity
Eva, K. W., Neville, A. J., & Norman, G. R. (1998) · Academic Medicine · doi:10.1097/00001888-199810000-00028 · Cited by 220 · see citing works
The impact of programmatic assessment on student learning: theory versus practice
Heeneman, S., Pool, A. O., Schuwirth, L., van der Vleuten, C. P. M., & Driessen, E. W. (2015) · Medical Education · doi:10.1111/medu.12645 · Cited by 213 · see citing works
Thirty years of illness scripts: Theoretical origins and practical applications
Custers, E. J. F. M. (2014) · Medical Teacher · doi:10.3109/0142159x.2014.956052 · Cited by 202 · see citing works
Technology‐enhanced Simulation in Emergency Medicine: A Systematic Review and Meta‐Analysis
Ilgen, J. S., Sherbino, J., & Cook, D. A. (2013) · Academic Emergency Medicine · doi:10.1111/acem.12076 · Cited by 199 · see citing works
The Etiology of Diagnostic Errors: A Controlled Trial of System 1 Versus System 2 Reasoning
Norman, G., Sherbino, J., Dore, K., Wood, T., Young, M., Gaissmaier, W., Kreuger, S., & Monteiro, S. (2014) · Academic Medicine · doi:10.1097/acm.0000000000000105 · Cited by 174 · see citing works
Ottawa 2020 consensus statement for programmatic assessment – 1. Agreement on the principles
Heeneman, S., de Jong, L. H., Dawson, L. J., WILKINSON, T. J., Ryan, A., Tait, G. R., Rice, N. E., Torre, D. M., Freeman, A., & van der Vleuten, C. P. M. (2021) · Medical Teacher · doi:10.1080/0142159x.2021.1957088 · Cited by 150 · see citing works
Self-citationBetter clinical decision making and reducing diagnostic error
Croskerry, P., & Nimmo, G. R. (2011) · The Journal of the Royal College of Physicians of Edinburgh · doi:10.4997/jrcpe.2011.208 · Cited by 148 · see citing works
Clinical reasoning processes: unravelling complexity through graphical representation
Charlin, B., Lubarsky, S., Millette, B., Crevier, F., Audétat, M., Charbonneau, A., Fon, N. C., Hoff, L., & Bourdy, C. (2012) · Medical Education · doi:10.1111/j.1365-2923.2012.04242.x · Cited by 147 · see citing works
Durning, S. J., Artino, A. R., Pangaro, L. N., van der Vleuten, C. P. M., & Schuwirth, L. (2010) · Academic Medicine · doi:10.1097/acm.0b013e3181d7427c · Cited by 141 · see citing works
Self-citationThe Relationship Between Response Time and Diagnostic Accuracy
Sherbino, J., Dore, K. L., Wood, T. J., Young, M. E., Gaissmaier, W., Kreuger, S., & Norman, G. R. (2012) · Academic Medicine · doi:10.1097/acm.0b013e318253acbd · Cited by 138 · see citing works
Schut, S., Maggio, L. A., Heeneman, S., van Tartwijk, J., van der Vleuten, C. P. M., & Driessen, E. W. (2020) · Perspectives on Medical Education · doi:10.1007/s40037-020-00625-w · Cited by 132 · see citing works
AI and Medical Education — A 21st-Century Pandora’s Box
Cooper, A. Z., & Rodman, A. M. (2023) · New England Journal of Medicine · doi:10.1056/nejmp2304993 · Cited by 128 · see citing works
The use of programmatic assessment in the clinical workplace: A Maastricht case report
Driessen, E. W., van Tartwijk, J., Govaerts, M., Teunissen, P., & van der Vleuten, C. P. M. (2012) · Medical Teacher · doi:10.3109/0142159x.2012.652242 · Cited by 116 · see citing works
Triola, M. M., & Burk-Rafel, J. (2023) · Academic Medicine · doi:10.1097/acm.0000000000005227 · Cited by 111 · see citing works
Mamede, S., van Gog, T., Moura, A. S., de Faria, R. M. D., Maria, J. P., & Schmidt, H. G. (2013) · Academic Medicine · doi:10.1097/acm.0000000000000076 · Cited by 109 · see citing works
Olson, A., Rencic, J., Cosby, K., Rusz, D., Papa, F., Croskerry, P., Zierler, B., Harkless, G., Giuliano, M. A., Schoenbaum, S., et al. (2019) · Diagnosis · doi:10.1515/dx-2018-0107 · Cited by 101 · see citing works
Self-citationEmbracing standardisation and contextualisation in medical education
Bates, J., Schrewe, B., Ellaway, R., Teunissen, P. W., & Watling, C. (2018) · Medical Education · doi:10.1111/medu.13740 · Cited by 100 · see citing works
Graber, M. L., Rusz, D., Jones, M. L., Farm-Franks, D., Jones, B., Gluck, J. C., Thomas, D. B., Gleason, K. T., Welte, K., Abfalter, J., et al. (2017) · Diagnosis · doi:10.1515/dx-2017-0022 · Cited by 98 · see citing works
From clinical decision support to clinical reasoning support systems
van Baalen, S., Boon, M., & Verhoef, P. (2021) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.13541 · Cited by 84 · see citing works
Deliberate reflection and clinical reasoning: Founding ideas and empirical findings
Mamede, S., & Schmidt, H. G. (2022) · Medical Education · doi:10.1111/medu.14863 · Cited by 83 · see citing works
Test‐enhanced learning of clinical reasoning: a crossover randomised trial
Raupach, T., Andresen, J. C., Meyer, K., Strobel, L., Koziolek, M. J., Jung, W. E., Brown, J., & Anders, S. (2016) · Medical Education · doi:10.1111/medu.13069 · Cited by 72 · see citing works
Merkebu, J., Battistone, M. J., McMains, K. C., McOwen, K. S., Witkop, C., Konopasky, A., Torre, D. M., Holmboe, E. S., & Durning, S. J. (2020) · Diagnosis · doi:10.1515/dx-2019-0100 · Cited by 72 · see citing works
Self-citationIlgen, J. S., Bowen, J. L., McIntyre, L. A., Banh, K. V., Barnes, D., Coates, W. C., Druck, J., Fix, M., Rimple, D., Yarris, L. M., et al. (2013) · Academic Medicine · doi:10.1097/acm.0b013e3182a31c1e · Cited by 68 · see citing works
Reflecting on Diagnostic Errors: Taking a Second Look is Not Enough
Monteiro, S., Sherbino, J., Patel, A., Mazzetti, I., Norman, G. R., & Howey, E. (2015) · Journal of General Internal Medicine · doi:10.1007/s11606-015-3369-4 · Cited by 67 · see citing works
Mamede, S., Splinter, T. A. W., van Gog, T., Rikers, R. M. J. P., & Schmidt, H. G. (2012) · BMJ Quality & Safety · doi:10.1136/bmjqs-2011-000518 · Cited by 65 · see citing works
Do extended matching multiple‐choice questions measure clinical reasoning?
Beullens, J., Struyf, E., & Damme, B. V. (2005) · Medical Education · doi:10.1111/j.1365-2929.2005.02089.x · Cited by 60 · see citing works
Understanding context specificity: the effect of contextual factors on clinical reasoning
Konopasky, A., Artino, A. R., Battista, A., Ohmer, M., Hemmer, P. A., Torre, D. M., Ramani, D., van Merriënboer, J. J. G., Teunissen, P. W., McBee, E. C., et al. (2020) · Diagnosis · doi:10.1515/dx-2020-0016 · Cited by 59 · see citing works
Self-citationClinical Gist and Medical Education
Lloyd, F. J. (2009) · JAMA · doi:10.1001/jama.2009.1383 · Cited by 56 · see citing works
Preparing Physicians for the Clinical Algorithm Era
Goodman, K. E., Rodman, A. M., & Morgan, D. J. (2023) · New England Journal of Medicine · doi:10.1056/nejmp2304839 · Cited by 56 · see citing works
Ottawa 2020 consensus statements for programmatic assessment – 2. Implementation and practice
Torre, D. M., Rice, N. E., Ryan, A., Bok, H. G. J., Dawson, L. J., Bierer, S. B., WILKINSON, T. J., Tait, G. R., Laughlin, T., Veerapen, K., et al. (2021) · Medical Teacher · doi:10.1080/0142159x.2021.1956681 · Cited by 55 · see citing works
Self-citationThe Management Script: A Practical Tool for Teaching Management Reasoning
Parsons, A. S., Wijesekera, T. P., & Rencic, J. J. (2020) · Academic Medicine · doi:10.1097/acm.0000000000003465 · Cited by 53 · see citing works
Self-citationDurning, S. J., Dong, T., Artino, A. R., van der Vleuten, C. P. M., Holmboe, E. S., & Schuwirth, L. (2015) · Perspectives on Medical Education · doi:10.1007/s40037-015-0196-6 · Cited by 46 · see citing works
Self-citationTorre, D. M., Schuwirth, L., van der Vleuten, C. P. M., & Heeneman, S. (2022) · Medical Teacher · doi:10.1080/0142159x.2022.2083487 · Cited by 44 · see citing works
Self-citationSchaye, V., Guzman, B., Burk-Rafel, J., Marin, M., Reinstein, I., Kudlowitz, D., Miller, L., Chun, J., & Aphinyanaphongs, Y. (2022) · Journal of General Internal Medicine · doi:10.1007/s11606-022-07526-0 · Cited by 44 · see citing works
Teamwork in clinical reasoning – cooperative or parallel play?
Olson, A. P. J., Durning, S. J., Fernandez Branson, C., Sick, B., Lane, K. P., & Rencic, J. J. (2020) · Diagnosis · doi:10.1515/dx-2020-0020 · Cited by 43 · see citing works
Self-citationSwapping Horses Midstream: Factors Related to Physiciansʼ Changing Their Minds About a Diagnosis
Eva, K. W., Link, C. L., Lutfey, K., & McKinlay, J. B. (2010) · Academic Medicine · doi:10.1097/acm.0b013e3181e16103 · Cited by 40 · see citing works
Peñuela-Epalza, M., & Villar, K. J. D. L. H.-D. (2018) · Medical Teacher · doi:10.1080/0142159x.2018.1487046 · Cited by 39 · see citing works
Norcini, J. J., Grabovsky, I., Barone, M., et al. (2023) · Academic Medicine · doi:10.1097/acm.0000000000005480 · Cited by 38 · see citing works
Deconstructing the diagnostic reasoning of human versus artificial intelligence
Pelaccia, T., Forestier, G., & Wemmert, C. (2019) · Canadian Medical Association Journal · doi:10.1503/cmaj.190506 · Cited by 35 · see citing works
Deliberate Practice at the Virtual Bedside to Improve Clinical Reasoning
Abdulnour, R.-E. E., Parsons, A. S., Muller, D., Drazen, J. M., Rubin, E. J., & Rencic, J. J. (2022) · New England Journal of Medicine · doi:10.1056/nejme2204540 · Cited by 32 · see citing works
Self-citationBoyle, J. G., Walters, M. R., Jamieson, S., & Durning, S. J. (2023) · Medical Teacher · doi:10.1080/0142159x.2023.2190479 · Cited by 32 · see citing works
Self-citationMutter, M. K., Martindale, J. R., Shah, N. L., Gusic, M. E., & Wolf, S. J. (2020) · Medical Science Educator · doi:10.1007/s40670-019-00904-0 · Cited by 29 · see citing works
Clinical Reasoning Curricula in Preclinical Undergraduate Medical Education: A Scoping Review
Hawks, M. K., Maciuba, J. M., Merkebu, J., Durning, S. J., Mallory, R., Arnold, M. J., Torre, D. M., & Soh, M. Y. (2023) · Academic Medicine · doi:10.1097/acm.0000000000005197 · Cited by 29 · see citing works
Self-citationIlgen, J. S., Bowen, J. L., Yarris, L. M., Fu, R. F., Lowe, R. A., & Eva, K. W. (2011) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.2011.01182.x · Cited by 28 · see citing works
Torre, D. M., Durning, S. J., Rencic, J. J., Lang, V., Holmboe, E. S., & Daniel, M. M. (2020) · Diagnosis · doi:10.1515/dx-2019-0098 · Cited by 28 · see citing works
Self-citationImproving Resident Feedback on Diagnostic Reasoning after Handovers: The LOOP Project
Lane, K. P., Chia, C., Lessing, J. N., et al. (2019) · Journal of Hospital Medicine · doi:10.12788/jhm.3262 · Cited by 27 · see citing works
Clinical Reasoning and Diagnostic Error: A Call to Merge Two Worlds to Improve Patient Care
Durning, S. J., Trowbridge, R. L., & Schuwirth, L. (2019) · Academic Medicine · doi:10.1097/acm.0000000000003041 · Cited by 26 · see citing works
Self-citationA situated cognition model for clinical reasoning performance assessment: a narrative review
Rencic, J. J., Schuwirth, L., Gruppen, L. D., & Durning, S. J. (2020) · Diagnosis · doi:10.1515/dx-2019-0106 · Cited by 26 · see citing works
Self-citationIs case-specificity content-specificity? An analysis of data from extended-matching questions
Dory, V., Gagnon, R. J., & Charlin, B. (2009) · Advances in Health Sciences Education · doi:10.1007/s10459-009-9169-z · Cited by 22 · see citing works
Hruska, P., Krigolson, O. E., Coderre, S., McLaughlin, K., Cortese, F., Doig, C. J., Beran, T., Wright, B. J., & Hecker, K. G. (2015) · Advances in Health Sciences Education · doi:10.1007/s10459-015-9649-2 · Cited by 20 · see citing works
Sequence matters: patterns in task-based clinical reasoning
Soh, M., Konopasky, A., Durning, S., Ramani, D., McBee, E. C., Ratcliffe, T. A., & Merkebu, J. (2020) · Diagnosis · doi:10.1515/dx-2019-0095 · Cited by 20 · see citing works
Self-citationReflection in Diagnostic Reasoning
Mamede, S., & Schmidt, H. G. (2014) · Academic Medicine · doi:10.1097/acm.0000000000000306 · Cited by 19 · see citing works
Chamberland, M., Mamede, S., Bergeron, L., et al. (2020) · Perspectives on Medical Education · doi:10.1007/s40037-020-00603-2 · Cited by 19 · see citing works
Situated cognition: clinical reasoning and error are context dependent
Daniel, M. M., Durning, S. J., Wilson, E. A., et al. (2020) · Diagnosis · doi:10.1515/dx-2020-0011 · Cited by 15 · see citing works
Self-citationExpanding boundaries: a transtheoretical model of clinical reasoning and diagnostic error
Daniel, M. M., Wilson, E. A., Seifert, C. M., et al. (2020) · Diagnosis · doi:10.1515/dx-2019-0102 · Cited by 14 · see citing works
Self-citationDistributed cognition: interactions between individuals and artifacts
Wilson, E. A., Seifert, C. M., Durning, S. J., et al. (2020) · Diagnosis · doi:10.1515/dx-2020-0012 · Cited by 11 · see citing works
Self-citationFramework and Schema are False Synonyms: Defining Terms to Improve Learning
Dreicer, J. J., Parsons, A. S., Joudi, T. F., Stern, S., Olson, A. P. J., & Rencic, J. J. (2023) · Perspectives on Medical Education · doi:10.5334/pme.947 · Cited by 11 · see citing works
Self-citationLearning How to Build Illness Scripts
Gavinski, K., Covin, Y. N., & Longo, P. J. (2018) · Academic Medicine · doi:10.1097/acm.0000000000002493 · Cited by 10 · see citing works
Improving Diagnosis: Adding Context to Cognition
Linzer, M., Sullivan, E. E., Olson, A. P. J., Khazen, M., Mirica, M., & Schiff, G. D. (2023) · Diagnosis · doi:10.1515/dx-2022-0058 · Cited by 10 · see citing works
Self-citationReframing context specificity in team diagnosis using the theory of distributed cognition
Boyle, J. G., Walters, M. R., Jamieson, S., & Durning, S. J. (2023) · Diagnosis · doi:10.1515/dx-2022-0100 · Cited by 10 · see citing works
Self-citationPutting Schemas to the Test: An Exercise in Clinical Reasoning
Minter, D. J., Manesh, R. S., Cornett, P. A., et al. (2018) · Journal of General Internal Medicine · doi:10.1007/s11606-018-4599-z · Cited by 9 · see citing works
Boyle, J. G., Walters, M. R., Jamieson, S., & Durning, S. J. (2021) · Teaching and Learning in Medicine · doi:10.1080/10401334.2021.1924723 · Cited by 8 · see citing works
Self-citationEcological psychology: diagnosing and treating patients in complex environments
Daniel, M. M., Torre, D. M., Durning, S. J., et al. (2020) · Diagnosis · doi:10.1515/dx-2020-0008 · Cited by 6 · see citing works
Self-citationEmbodied cognition: knowing in the head is not enough
Daniel, M. M., Wilson, E. A., Torre, D. M., et al. (2020) · Diagnosis · doi:10.1515/dx-2020-0004 · Cited by 5 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Large Language Models lack essential metacognition for reliable medical reasoning
Griot, M., Hemptinne, C., Vanderdonckt, J., & Yuksel, D. (2025) · Nature Communications · doi:10.1038/s41467-024-55628-6 · Cited by 113 · see citing works
“Comprehensive models of cognition, such as the transtheoretical model 31 incorporate external factors, including interactions with team members or databases, which could be implemented for LLMs with Retrieval Augmented Generation 31 .”
- Authors
- Parsons, A. S., Wijesekera, T. P., Olson, A. P. J., Torre, D., Durning, S. J., & Daniel, M.
- Affiliations
- University of Virginia (US)
- Yale University (US)
- University of Minnesota (US)
- University of Central Florida (US)
- Uniformed Services University of the Health Sciences (US)
- University of California San Diego (US)
- Corresponding author
- Parsons, Andrew S.
- ORCID
- Venue
- Medical Teacher
- Publisher
- Informa UK Limited
- Published
- 2024-06-05
- Volume
- 47
- Issue
- 4
- Pages
- 665-676
- ISSN
- 0142-159X (ISSN-L)
- 1466-187X
- OpenAlex
- W4399357279
- Cited by
- 12
- References
- 100
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 2
- FWCI
- 6.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Teacher (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Keywords
- clinical reasoning, medical errors, dual-process theory, fast and slow thinking, transtheoretical model, medical education, clinical reasoning assessment, complex cognition
- MeSH terms
- Clinical Reasoning, Clinical Competence, Cognition, Education, Medical, Humans, Models, Psychological, Models, Theoretical, Teaching, Thinking, Models, Educational, Medical Errors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
