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Reflecting on diagnosis: The Metacognitive Diagnostic Reasoning Model ©.

Sarah L Beebe1, Angela M McNelis2, Majeda El-Banna3

  • 1Bayhealth Medical Center, Dover, DE.

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The Metacognitive Diagnostic Reasoning (MDR) Model enhances diagnostic reasoning in Advanced Practice Registered Nurses (APRNs) by emphasizing metacognition. This model offers a framework for research and education to improve diagnostic accuracy and patient care.

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Area of Science:

  • Nursing
  • Cognitive Science
  • Medical Education

Background:

  • Diagnostic reasoning integrates intuitive and deliberate cognitive processes.
  • Interventions to improve diagnostic reasoning lack consistency due to varied terminology and models.
  • Advanced Practice Registered Nurses (APRNs) engage in complex diagnostic reasoning.

Purpose of the Study:

  • To introduce the Metacognitive Diagnostic Reasoning (MDR) Model © for APRNs.
  • To synthesize literature supporting the MDR Model's factors.
  • To provide a structured framework for understanding diagnostic reasoning.

Main Methods:

  • Systematic literature review from inception to August 2023.
  • Inclusion of database searches, historical articles, texts, and documents.
  • Analysis of 41 relevant sources.

Main Results:

  • Metacognition is central to the MDR Model, driving diagnostic reasoning.
  • The model incorporates dual cognitive processing and knowledge representation.
  • APRNs utilize metacognition for iterative improvement of diagnostic processes.

Conclusions:

  • The MDR Model offers a unified framework for diagnostic reasoning research and education.
  • It facilitates the development and testing of interventions to improve diagnostic skills.
  • The model supports evidence-based practice, aiming to reduce diagnostic errors and enhance patient outcomes.