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The historical tendency to view medicine as both an art and a science may have contributed to a disinclination among clinicians towards cognitive science. In particular, this has had an impact on the approach towards the diagnostic process which is a barometer of clinical decision-making behaviour and is increasingly seen as a yardstick of clinician calibration and performance. The process itself is more complicated and complex than was previously imagined, with multiple variables that are difficult to predict, are interactive, and show nonlinearity. They appear to characterise a complex adaptive system. Many aspects of the diagnostic process, including the psychophysics of signal detection and discrimination, ergonomics, probability theory, decision analysis, factor analysis, causal analysis and more recent developments in judgement and decision-making (JDM), especially including the domain of heuristics and cognitive and affective biases, appear fundamental to a good understanding of it. A preliminary analysis of factors such as manifestness of illness and others that may impede clinicians' awareness and understanding of these issues is proposed here. It seems essential that medical trainees be explicitly and systematically exposed to specific areas of cognitive science during the undergraduate curriculum, and learn to incorporate them into clinical reasoning and decision-making. Importantly, this understanding is needed for the development of cognitive bias mitigation and improved calibration of JDM in clinical practice.

Diagnostic errors comprise the leading threat to patient safety in healthcare today. Learning how to extract the lessons from cases where diagnosis succeeds or fails is a promising approach to improve diagnostic safety going forward. We present up-to-date and authoritative guidance on how the existing approaches to conducting root cause analyses (RCA's) can be modified to study cases involving diagnosis. There are several diffierences: In cases involving diagnosis, the investigation should begin immediately after the incident, and clinicians involved in the case should be members of the RCA team. The review must include consideration of how the clinical reasoning process went astray (or succeeded), and use a human-factors perspective to consider the system-related contextual factors in the diagnostic process. We present detailed instructions for conducting RCA's of cases involving diagnosis, with advice on how to identify root causes and contributing factors and select appropriate interventions. [ABSTRACT FROM AUTHOR]

Rationality Cognitive scientists have argued that the most important characteristic of decision making is rationality [[11], [18]], yet it is widely accepted that decision makers in all domains of human behavior consistently exhibit failures in rationality. Critical thinking The principles of critical thinking (CT), described by the Foundation for Critical Thinking [[35]], have been widely endorsed in multiple domains, including medicine [[36]]. Critical thinking (CT), diagnostic error, distributed cognition, lateral thinking, rationality, medical humanities, metacognition, mindware gap Keywords: critical thinking (CT); diagnostic error; distributed cognition; lateral thinking; medical humanities; metacognition; mindware gap; rationality EN critical thinking (CT) diagnostic error distributed cognition lateral thinking medical humanities metacognition mindware gap rationality 176 183 8 05/12/22 20220501 NES 220501 An unsettling logic has unfolded in healthcare over the last decade or so. [Extracted from the article]

Following a review of accepted submissions for this special issue of the Society for Academic Emergency Medicine (SAEM)'s collected papers on diagnosis, we offer a commentary on the variety of reports. We use the metaphor of Newton's demonstration that a complex percept like the rainbow can be broken down by prisms, into a collection of different wavelengths of light. Like Feynman, we believe that the beauty of something may be revealed and augmented by reducing it to its constituent parts., (© 2025 The Author(s). Academic Emergency Medicine published by Wiley Periodicals LLC on behalf of Society for Academic Emergency Medicine.)