Abstract
[This is an excerpt.] Diagnostic reasoning has historically been treated as intrinsic to the individual clinician, likely due to difficulty visualizing and measuring cognition based on the inherent complexity and internal nature of mental processes. However, there is now growing recognition that cognition is complex and affected by context, cognitive biases, resources, and physical, social, and technological environments. Increasing attention is also being given to cognitive load theory (CLT), an educational model for how human memory and processing occur, with a focus on how to optimize the limited resources of cognitive capacity. Studies have already found that cognitive overload reduces decision-making flexibility, is associated with task errors, and can promote default thinking rather than conscious and analytical thinking. However, CLT as it applies to diagnostic accuracy is a relatively new area of study, with most of the research occurring in the last 5 to 10 years. This AHRQ brief will provide a broad overview of fundamental CLT concepts, discuss what is and is not yet known about the interplay between CLT and diagnostic accuracy, and review ways to measure CLT to understand its causal impact on diagnostic accuracy. The brief will conclude with recommendations for future research and improvement efforts, with the goal of better understanding how cognitive load affects diagnostic accuracy and how to optimize cognition to decrease diagnostic error-related morbidity and mortality. A clinical vignette will be woven throughout the paper to better illustrate the concepts and provide clinical context. [To read more, click View Resource.]
