3. Making a diagnosis, decision making and reasoning

This is about a conscious, structured approach to making diagnoses and decision-making. The focus is on the content and includes all the steps leading up to formulating a diagnosis or problem list. This also includes diagnostic accuracy that does not necessarily require the correct diagnosis, but that the direction of reasoning was appropriate and accurate. The trainee’s ability to think about and reflect on their reasoning is another aspect of this assessment domain. This competency is closely aligned with information gathering; however, it can also be assessed in different ways.

Criteria

1. Integrates and synthesises knowledge to make decisions in complex clinical situations
2. Modifies differential diagnoses based on clinical course and other data as appropriate
3. Demonstrates diagnostic accuracy - this does not require the correct diagnosis, but that the direction of reasoning was appropriate and accurate
4. Collects/reports clinical information in a hypothesis driven manner
5. Articulates an appropriate problem definition
6. Formulates a rational list of differential diagnoses (including most likely, less likely, unlikely and can’t miss diagnoses)
7. Directs evaluation and treatment towards high priority diagnoses
8. Demonstrates metacognition (thinking about own thinking)

Aboriginal and Torres Strait Islander health context

5. Demonstrate effective diagnostic and management strategies that enhance health outcomes for Aboriginal and Torres Strait Islander patients