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The diagnostic process is a fundamental element of practice in the clinical and healthcare fields in particular, both for its repercussions on patient healing and care and for the professionalism with which healthcare professionals carry out their roles. Deriving from the Greek dia-gnosis (knowing through), the diagnostic process is the cognitive process implemented by a healthcare professional in his or her work. Although “diagnosis,” at the level of common sense, is more widely used as a noun, it should be noted that the diagnostic process recalls the path of discovery implemented by professionals in reference to their categories of observation, leading to a definition of their work object. As part of an operation on the cardiovascular system, a surgeon will mainly work on the biochemical implications of that body part, while a physician struggling with the decision to conduct a plastic surgery on the face could have as an object not only the face but also the story of the person requesting the intervention. On closer inspection, the physician’s observational and professional skills interact with the patient’s communicative skills, and this exchange may occur according to different interactive modalities (compliance). Indeed, information on some medical history could only emerge with by creating the favorable relational conditions (Kripalani et al., 2007; Sanders, 2009; Castelnuovo, 2013). Furthermore, this interactive dynamism is influenced by the context in which it occurs and by the objectives of the healthcare structure. Far from being a mechanistic action, the diagnostic process entails a broad and varied complexity, which requires a suitable management capacity (decision making). Research in the healthcare field has found that 44% of the general errors made by healthcare personnel concern the diagnostic process (Shiff et al., 2009). One-third of these errors, as some studies claim, has a cognitive nature (Pepe et al., 2012), and the greatest difficulties concern the processing of the contents found (Turchi and Perno, 2004; Croskerry, 2008). This demonstrates the need to increasingly refine the reasoning at the base of the diagnostic process. In this work, we intend to highlight the possible critical implications during the gnoseological process performed by the staff in clinical and healthcare contexts and, at the same time, to systematize some methodological principles useful to reduce the so-called Cognitive Dispositions to Respond (CDRs), which can lead to diagnostic errors.

Methodological Bias That Can Reduce (or Affect) the Process of Diagnostic Construction in Clinical Settings