Blink or think: can further reflection improve initial diagnostic impressions?
Hess BJ, Lipner RS, Thompson V, Holmboe ES, Graber ML. Acad Med. 2014 Nov 4; [Epub ahead of print].
This direct observation study examined cognition among experienced clinicians in the setting of their recertification examination and found that when they changed answers, it was usually from an incorrect to a correct response. This suggests that further reflection enhances accuracy compared to intuitive response, consistent with work on metacognition to enhance diagnostic accuracy.
Physicians' diagnostic accuracy, confidence, and resource requests: a vignette study.
Meyer AND, Payne VL, Meeks DW, Rao R, Singh H. JAMA Intern Med. 2013;173:1952-1958.
Use of a novel, modified fishbone diagram to analyze diagnostic errors.
Reilly JB, Myers JS, Salvador D, Trowbridge RL. Diagnosis. 2014;1:167-171.
Skin-deep diagnosis: affective bias and zebra retreat complicating the diagnosis of systemic sclerosis.
Miller CS. Am J Med Sci. 2013;345:53-56.
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Are you a great diagnostician?
Yasgur BS. Medscape Business of Medicine. March 27, 2013.