Table 1.

Theoretical Frameworks for Diagnostic Reasoning¹⁴

	Information processing theory	Situativity theory
Where is the center of the DR process?	Clinician’s mind	Clinical interactions
What facilitates accurate DR?	Well-organized and well-developed knowledge structures (e.g., diagnostic schemas) and mental models (e.g., illness scripts)	Well-developed knowledge structures and the ability to manage the dynamic, complex interactions in clinical environments
Examples in practice	Organizing causes of chest pain into cardiac, pulmonary, gastrointestinal, and musculoskeletal causes Developing illness scripts that include differentiating features (e.g., findings that distinguish acute myocardial infarction from acute pericarditis)	Considering how patient-physician communication influences the probability the physician assigns to different diagnoses (e.g., acute coronary syndrome and gastroesophageal reflux) Recognizing how the ability to access a patient’s prior cardiac stress test results in the electronic health record plays a role framing diagnostic probabilities

Information processing theory

Situativity theory

Where is the center of the DR process?

Clinician’s mind

Clinical interactions

What facilitates accurate DR?

Well-organized and well-developed knowledge structures (e.g., diagnostic schemas) and mental models (e.g., illness scripts)

Well-developed knowledge structures and the ability to manage the dynamic, complex interactions in clinical environments

Examples in practice

Organizing causes of chest pain into cardiac, pulmonary, gastrointestinal, and musculoskeletal causes

Developing illness scripts that include differentiating features (e.g., findings that distinguish acute myocardial infarction from acute pericarditis)

Considering how patient-physician communication influences the probability the physician assigns to different diagnoses (e.g., acute coronary syndrome and gastroesophageal reflux)

Recognizing how the ability to access a patient’s prior cardiac stress test results in the electronic health record plays a role framing diagnostic probabilities

Abbreviations: DR diagnostic reasoning