Associative thinking as a lever for diagnostic creativity

Creativity plays an important role in diagnostic reasoning, particularly in supporting calibration and insights. However, the cognitive mechanisms underlying creativity have not yet been clearly articulated in this context. This study focused on associative thinking, an essential component of creativity, and conducted a systematic examination in the context of diagnostic reasoning. To the best of our knowledge, this is the first such study. Specifically, this study explored how the four types of associative thinking-remote, chained, radial, and dissociative-contribute to the generation of diagnostic hypotheses by examining clinical cases. This article presents a theoretical reinterpretation, grounded in the cognitive perspectives of sophisticated reasoning processes routinely employed by expert clinicians. By illuminating the role of associative thinking in diagnostic hypothesis generation, this study provides a novel conceptual perspective that aims to enhance both creativity and diagnostic accuracy, ultimately contributing to improved quality of patient care.