Cognitive psychology and medical diagnosis

Abstract The nature and acquisition of complex cognitive skills have been intensively investigated over the past 20 years. From such studies in non‐medical domains it appears that experts (a) generally remember new information in their field better than do the less expert; (b) work forward to solutions; (c) form superior representations of problems; (d) are superior in knowledge, not in basic processing abilities; and (e) require extensive practice over a period of years to achieve expert status. Studies of expertise in medical diagnosis have found two major departures from the typical findings in other areas of expertise, viz . that memory for new information seems best at intermediate levels of skill rather than at high levels, and that a mixture of forward and backward reasoning (hypothetico‐deductive inference) is common at all levels of skill in medical diagnosis. These departures from findings in other domains are explained by the special characteristics of both medical knowledge and the diagnostic task.