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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.
Journal of the American Association of Nurse Practitioners
|December 4, 2024
Summary
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.
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.
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