Improving diagnosis: adding context to cognition

Background: The environment in which clinicians provide care and think about their patients is a crucial and undervalued component of the diagnostic process. Content: In this paper, we propose a new conceptual model that links work conditions to clinician responses such as stress and burnout, which in turn impacts the quality of the diagnostic process and finally patient diagnostic outcomes. The mechanism for these interactions critically depends on the relationship between working memory (WM) and long-term memory (LTM), and ways WM and LTM interactions are affected by working conditions. Summary: We propose a conceptual model to guide interventions to improve work conditions, clinician reactions and ultimately diagnostic process, accuracy and outcomes. Outlook: Improving diagnosis can be accomplished if we are able to understand, measure and increase our knowledge of the context of care.