The Use of Cognitive Reasoning in Medicine

Building from the concepts of schemata and cognitive load theory, pathologists and cytotechnologists alike uses cognitive reasoning processes such as perception, attention, memory, and search to collect data from the case, including radiologic, macroscopic and microscopic findings (Pena & de Souza Andrade-Filho, 2009).  For example, when looking at a histologic (tissue) slide, the pathologists can make a diagnosis based on a strategy called “pattern recognition.”  Pattern recognition is the realization of previously learned picture of the tissue.  It is committed to the memory and automatic, similar to the chess player example above (Pena & Andrade-Filho, 2009).

Although cognitive skills considered the very basis of every diagnostic and prognostic action that physician’s uses, medical science have developed few methods to facilitate acquisition and mastery of these skills (Sandhu & Carpenter, 2006).  Kassirer & Kopelman (1991) argued that “instead of teaching how diagnostic hypotheses are initiated, refined, and treatment procedures formulated – teachers of clinical medicine have substituted standardized histories and physicals, formal approaches to recording patient problems, and lock-step algorithmic charts for blind guidance, none of these methods focusing on essential cognitive reasoning processes,” (cited in Sandhu & Carpenter, 2006).

However, in the last few decades, there has been a considerable growth seen in the understanding of human reasoning through cognitive sciences, decision theory, computer sciences, and artificial intelligence. These sciences provide insight into the critical cognitive processes that physician’s uses on their day-to-day undertakings.

Intervention Strategies

Cognitive psychologists were first to introduce instructional interventions on their basic research projects. An experiment by Brown and VanLehn (1980) resulted in the creation of a computer game which helped students identify their buggy procedure and fix them with appropriate instruction (cited in Vosniadou, 1996). In yet another intervention, Palinscar and Brown (1984) employed the use of meta-cognitive strategies necessary for skilled reading which resulted in the creation of reciprocal teaching method. This method is a form of dialogue between teacher and student where the teacher models the meta-cognitive strategies for text comprehension, (e.g. summarizing, questioning, clarifying, and predicting), then leads the students to a group task to decipher the meaning of the text (cited in Vosniadou, 1996).

Meta-cognition is also the process by which pathologists and cytotechnologists uses to arrive at a diagnosis.  These professionals uses cognitive reasoning processes such as perception, attention, memory, and search to collect data from the case, including radiologic, macroscopic and microscopic findings (Vosniadou, 1996; Pena &  Andrade-Filho, 2009).

Cesar Aquino, PhD, MBA, CT(ASCP)