On the method of diagnosis.

Area of Science:

• Medical Education
• Clinical Reasoning
• Epistemology

Background:

• Diagnostic reasoning is crucial in medicine but poorly explained in education.
• Existing approaches lack explicit structure for teaching diagnostic thought processes.

Purpose of the Study:

• To present a five-step model of diagnostic reasoning.
• To provide a theoretical framework for understanding and teaching clinical diagnosis.
• To integrate existing diagnostic approaches by clarifying their underlying reasoning structure.

Main Methods:

• Developed a five-step model based on coherence-based epistemology and abductive inference.
• Described diagnosis as a convergence process from data to a coherent explanatory frame.
• Integrated existing theories like dual-process theory and Bayesian updating.

Main Results:

• The model outlines five recursive phases: problem framing, perspective construction, constraint application, stabilization, and clarification.
• It offers criteria for assessing diagnostic coherence and supports structured feedback.
• The framework makes diagnostic reasoning transparent and teachable.

Conclusions:

• Diagnosis is defined by the capacity to construct a coherent explanatory model, not just classification or probability.
• The model serves as a scaffold for reasoning transparency, reflective practice, and formative instruction.
• Provides a theoretical foundation for studying and teaching diagnostic coherence, awaiting empirical validation.