Diagnostic Expertise in the Emergency Department

https://journals.sagepub.com/doi/10.1177/15553434251335732 Story building, technical expertise, and teamwork are among the most common clinical skills linked to diagnostic success in the emergency department (ED), according to a recent AHRQ-funded study in the Journal of Cognitive Engineering and Decision Making. Unlike much existing research, the article examines aspects of diagnostic expertise rather than error. Researchers conducted in-depth interviews with 43 providers from diverse roles and hospital settings, eliciting a total of 60 diagnostically challenging incidents that occurred in an ED. Following multiple iterations of qualitative analysis, the study found that in 63 percent of cases, providers used story building—making sense of a patient’s symptoms by “connecting the dots” with a feasible narrative—to reach a correct diagnosis. Technical expertise contributed to 58 percent, and teamwork with other healthcare providers played a role in 55 percent of the incidents. Access the abstract to learn more about these and other areas of diagnostic expertise.