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Henk Schmidt Professor

Clinical reasoning

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The ultimate goal of medical education is to support students in developing problem-solving capabilities to deal appropriately with the problems of their patients. Problem solving in medicine is difficult because the problems doctors are confronted with on a daily basis are ill-defined. Signs and symptoms of different diseases show considerable overlap, while on the other hand, the same disease can manifest itself in quite different guises. Understanding how students and experts in this field handle such problems is crucial both for training and practice. My research team is particularly interested in studying educational strategies to improve diagnostic reasoning and in the sources of cognitive error.

While many educational strategies have been tried out to improve diagnostic problem solving, most of them have only limited success. According to two recent reviews, the only cognitive intervention reliably enhancing diagnostic reasoning is deliberate reflection, an intervention developed by our research team. Deliberate reflection requires students to match signs and symptoms in a clinical case with self-produced diagnostic hypotheses to find out which diagnosis fits best with the data.

A second research finding of our team, namely that bias in diagnostic reasoning is not so much caused by thinking errors but rather by lack of appropriate knowledge of symptoms discriminating between look-alike diseases, makes the work of IMERR stand out internationally.

I hope that my work has been and is a contribution to the improvement of the training of medical students. In addition, a better understanding of clinical reasoning is in my view one of the factors that contribute to promoting safe patient care.

Anyone with questions about cognitive determinants of clinical reasoning can get in touch with me.

Overview of Henk's publications: click here