Advances in Health Sciences Education

, Volume 14, Supplement 1, pp 19-25

First online:

What makes diagnosis hard?

  • Robert L. WearsAffiliated withDepartment of Emergency Medicine, University of Florida Health Science Center, JacksonvilleClinical Safety Research Unit, Imperial College London Email author 

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This essay uses a case study to explore some of the reasons why understanding failures associated with diagnosis seems to have lagged behind the attention and understanding directed at failures in other aspects of healthcare (e.g., wrong patient/procedure, medication misadministration, etc). The goal is not to pose an alternative to many of the current ideas about problems in diagnosis, but rather to enrich the discussions.


Cognition Hindsight bias Joint cognitive systems Mis-diagnosis Sense-making Patient safety