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A Reflective Verbalization Strategy to Trigger Alternative Diagnostic Hypotheses.

Sho Isoda1,2,3, Taro Shimizu3,4,5, Tadayuki Hashimoto1

  • 1Department of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Osaka, Japan.

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|September 8, 2025
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Summary
This summary is machine-generated.

Physicians can improve diagnostic accuracy by articulating gut feelings (GFs) using reflective verbalization (RV). The DATES approach helps refine clinical reasoning and overcome diagnostic biases.

Keywords:
creativitydebiasingdiagnostic excellencegut feelinginsightreflective verbalization

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Area of Science:

  • Cognitive Psychology
  • Clinical Reasoning
  • Medical Education

Background:

  • Physicians often experience gut feelings (GFs) during diagnosis, indicating potential errors in hypotheses.
  • Articulating these GFs is crucial for accurate diagnosis and problem-solving.

Purpose of the Study:

  • To introduce reflective verbalization (RV) as a method for physicians to articulate and utilize their GFs.
  • To enhance clinical reasoning and diagnostic hypothesis refinement through metacognitive strategies.

Main Methods:

  • The DATES approach (Degree, Abandoned, Time course, Excess, Shortage) is proposed for systematic GF articulation.
  • This method involves comparing patient data against illness scripts to ensure comprehensive evaluation.

Main Results:

  • The DATES approach facilitates consideration of differential diagnoses.
  • It aids in overcoming cognitive biases such as confirmation and anchoring biases.

Conclusions:

  • The DATES approach, combined with RV, improves physicians' clinical reasoning and decision-making.
  • This tool is valuable for healthcare professionals facing diagnostic uncertainty or contradictory findings.