Diagnostic reasoning and treatment planning: I. Diagnosis.

Information-processing research into the natural process of clinical reasoning is reviewed and the University of Vermont diagnostic reasoning research project is described. Experienced psychiatric diagnosticians use a hypothetico-deductive logic. The development of a profile of diagnostic competencies is outlined and a course in diagnostic reasoning for medical students, which specifically objectified the tactics and strategy of reasoning and resulted in a significant improvement in the profile of competencies, is described. Finally, the organisation of a diagnostic formulation is discussed.

How do psychiatrists think? Clinical reasoning in the psychiatric interview: a research and education project.

This paper describes a model of the clinical process in psychiatry. Research into the clinical reasoning of physicians is reviewed. Experimental work at the University of Vermont has demonstrated systematic differences between medical students and psychiatrists of different levels of experience, in regard to the logical order and complexity of clinical reasoning. A psychiatric educational program which objectifies cue recognition, clinical inference, hypothesis generation and systematic enquiry has been associated with changes in reasoning. This suggests that the acquisition of efficient diagnostic reasoning strategies could be accelerated by appropriately designed educational programs.