In 2015, the National Academy of Medicine (NAM) published a comprehensive monograph titled “Improving Diagnosis in Health Care”; a report identifying diagnostic error as one of America’s most urgent health care concerns. Among the many sub-optimal outcomes associated with diagnostic error was the frequency with which it caused unnecessary death with some authorities estimating from 250,000 to 400,000 deaths occurring annually; estimates ranking diagnostic error as the third leading cause of death in America (behind cardiovascular disease and cancer). In its search for root causes, NAM argued that America’s medical training programs and licensing boards were “not adequately preparing individuals to become skilled diagnosticians” and subsequently recommended that medical educators develop diagnostic training approaches “aligned with evidence from the learning sciences”. The study described herein represents an approach to training in differential diagnosis based upon a learning sciences-driven, theoretical framework called Dual Processing Theory DPT). Results suggest that DPT’s ‘System 2’ based approach to developing diagnostic knowledge and reasoning can improve the diagnostic capabilities of year two medical students. The authors will also demonstrate how this approach is being transformed into a computer-based diagnostic training tool which could serve as a generalizable, web-based approach to System 2 based diagnostic training.
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