Clinical Diagnosis as a Dynamic Cognitive Process: Application of Bloom’s Taxonomy for Educational Objectives in the Cognitive Domain

Abstract

Making a diagnosis is the pivotal cognitive activity of a practicing physician. Correct diagnosis usually leads to appropriate treatment. Clinical diagnosis a very dynamic cognitive process. It has tended to remain a sub-conscious activity and has been studied mostly as a complex categorization task, from fixed points of view. Bloom’s taxonomy of the cognitive domain classifies the cognitive process into six dynamic levels of increasing complexity, from knowledge as the baseline, through comprehension, application, analysis, synthesis, to evaluation as the highest level. This classification, if appreciated by medical teachers and students and correctly applied, should make meta-cognition of the diagnostic process routine. The most ‘sub-conscious’ thoughts can be brought to ‘consciousness’ and thus become ‘teachable’. A sample case summary is used as an example to illustrate the application of the Bloom’s taxonomy for meta-cognition of the diagnostic process.