Abstract
BackgroundDiagnostic reasoning refers to the cognitive processes by which clinicians formulate diagnoses. Despite the implications for patient safety and professional identity, research on diagnostic reasoning in osteopathy remains largely theoretical. The aim of this study was to investigate the influence of perceived task difficulty on the diagnostic reasoning of students osteopaths.MethodsUsing a single-blinded, cross sectional study design, sixteen final year pre-registration osteopathy students diagnosed two standardized cases under two context conditions (complex versus control). Context difficulty was manipulated via verbal manipulation and case order was randomized and counterbalanced across subjects to ensure that each case was diagnosed evenly under both conditions (i.e. half of the subjects performed either case A or B first). After diagnosis, participants were presented with items (literal, inferred and filler) designed to represent analytical and non-analytical reasoning. Response time and error rate for each item were measured. A repeated measures analysis of variance (concept type x context) was performed to identify differences across conditions and make inferences on diagnostic reasoning.ResultsParticipants made significantly more errors when judging literal concepts and took significantly less time to recognize filler concepts in the complex context. No significant difference in ability to judge inferred concepts across contexts was found.ConclusionsAlthough speculative and preliminary, our findings suggest the perception of complexity led to an increased reliance on analytical reasoning at the detriment of non-analytical reasoning. To reduce the associated cognitive load, osteopathic educational institutions could consider developing the intuitive diagnostic capabilities of pre-registration students. Postgraduate mentorship opportunities could be considered to enhance the diagnostic reasoning of professional osteopaths, particularly recent graduates. Further research exploring the influence of expertise is required to enhance the validity of this study.
Highlights
Diagnostic reasoning refers to the cognitive processes by which clinicians formulate diagnoses
Diagnostic reasoning (DR) refers to the cognitive processes by which healthcare practitioners formulate diagnoses [1]. Faults in these processes such as cognitive biases have been attributed as a cause of diagnostic error in medicine, a wealth of research has been directed at understanding their intricacies [2]
Future research on osteopathic DR may benefit from exploiting the recommendations provided by the medical literature, namely the need for ecological designs with a focus on the influence of contextual factors. The aim of this present study was to replicate Mamede et al.’s [2] experiment to investigate the influence of perceived task complexity on the DR of student osteopaths
Summary
Diagnostic reasoning refers to the cognitive processes by which clinicians formulate diagnoses. Diagnostic reasoning (DR) refers to the cognitive processes by which healthcare practitioners formulate diagnoses [1] Faults in these processes such as cognitive biases have been attributed as a cause of diagnostic error in medicine, a wealth of research has been directed at understanding their intricacies [2]. Despite focusing on different aspects of the decision-making process, all of these theories share the common principle that reasoning is governed by two distinct cognitive systems [6]. This principle was applied by Croskerry [7] to generate a pragmatic unifying model describing each system and their interplay during DR
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
