Abstract
This essay uses a case study to explore some of the reasons why understanding failures associated with diagnosis seems to have lagged behind the attention and understanding directed at failures in other aspects of healthcare (e.g., wrong patient/procedure, medication misadministration, etc). The goal is not to pose an alternative to many of the current ideas about problems in diagnosis, but rather to enrich the discussions.
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References
Box, G. E. P. (1976). Science and statistics. Journal of the American Statistical Association, 71, 791–799.
Brehmer, B. (1987). Development of mental models for decision in technological systems. In J. Rasmussen, K. Duncan, & J. Leplat (Eds.), New technology and human error (pp. 111–120). Chichester, UK: Wiley.
Brooks, L. R., LeBlanc, V. R., & Norman, G. R. (2000). On the difficulty of noticing obvious features in patient appearance. Psychological Science, 11(2), 112–117.
Croskerry, P., & Norman, G. (2008). Overconfidence in clinical decision making. The American Journal of Medicine, 121(5), S24–S29.
Evans, J. S. B. T. (2008). Dual-processing accounts of reasoning, judgment, and social cognition. Annual Review of Psychology, 59(1), 255–278.
Henriksen, K., & Kaplan, H. (2003). Hindsight bias, outcome knowledge and adaptive learning. Quality and Safety in Health Care, 12(Suppl 2), ii46–ii50.
Hollnagel, E., & Woods, D. D. (2006). Joint cognitive systems: Foundations of cognitive systems engineering. Boca Raton, FL: CRC Press/Taylor & Francis Group.
Hutchins, E. (1996). Cognition in the wild. Cambridge, MA: MIT Press.
Klein, G. (2008). Naturalistic decision making. Human Factors: The Journal of the Human Factors and Ergonomics Society, 50, 456–460.
Klein, G., Pliske, R., Crandall, B., & Woods, D. D. (2005). Problem detection. Cognition, Technology & Work, 7(1), 14–28.
Norman, G. R., & Brooks, L. R. (1997). The non-analytical basis of clinical reasoning. Advances in Health Sciences Education: Theory and Practice, 2(2), 173–184.
Norman, G., Young, M., & Brooks, L. (2007). Non-analytical models of clinical reasoning: The role of experience. Medical Education, 41(12), 1140–1145.
Parasuraman, R., Sheridan, T. B., & Wickens, C. D. (2000). A model for types and levels of human interaction with automation. IEEE Transactions on Systems, Man and Cybernetics: Part A, 30(3), 286–297.
Raiffa, H. (1970). Decision analysis: Introductory Lectures on choices under uncertainty. Reading, MA: Addison-Wesley.
Rasmussen, J. (1993). Diagnostic reasoning in action. IEEE Transactions on Systems, Man and Cybernetics, Part A, 23(4), 981–992.
Rittel, H. W. J., & Webber, M. M. (1973). Dilemmas in a general theory of planning. Policy Sciences, 4(2), 155–169.
Rudolph, J. W., Morrison, J. B., & Carroll, J. S. (2009, in press). The dynamics of diagnosing: action-oriented problem solving in fast-paced, high-stakes settings. Academy of Management Review, 34(4).
Vicente, K. J. (1999). Cognitive work analysis. Mahwah, NJ: Lawrence Erlbaum Associates.
Weick, K. E. (1995). Sense making in organizations. Thousand Oaks, CA: Sage.
Woods, D. D., & Hollnagel, E. (2006). Joint cognitive systems: Patterns in cognitive systems engineering. Boca Raton, FL: CRC Press/Taylor & Francis Group.
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Wears, R.L. What makes diagnosis hard?. Adv in Health Sci Educ 14 (Suppl 1), 19–25 (2009). https://doi.org/10.1007/s10459-009-9181-3
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DOI: https://doi.org/10.1007/s10459-009-9181-3