摘要：With the rapidly increasing access to brain imaging facilities, we are potentially at the dawn of a new era for understanding diagnostic reasoning. Although, this may sound bold, and appears to echo the many claims made in other disciplines, we will highlight in this paper why neuroscience can be a useful tool for advancing diagnostic reasoning research. But first some cautionary notes. Fact is that all too often the high expectations of neuroscience are not met, such as the expectation in “educational neuroscience” that the insights of the brain will transform classroom teaching and learning.1 There is currently no compelling evidence that this has happened on any scale.2 Therefore, a healthy dose of scepticism is required when considering the potential role neuroscience can play in the understanding of diagnostic reasoning. With that in mind, we do however believe that the role neuroscience can play in advancing our understanding of diagnostic reasoning is quite different compared with education. Here, the primary objective is not to pursue a wholesale change of educational practice, but to test a fundamental assumption of a cognitive theory that claims to help our understanding of what diagnostic reasoning is about; Dual-Process Theory.3 Dual-Process Theory claims that there are two systems in the brain. System 1 is considered intuitive, fast and reliant on automatic activation of “illness scripts” stored in memory and leading to effortless pattern recognition. System 2 on the other hand is considered analytic, slow, deliberate, and systematic. The clinical reasoning literature is divided; one group of researchers defending System 1 reasoning as the hallmark of expert decision-making, whereas the other camp of researchers considering System 2 reasoning as superior and more likely to achieve diagnostic accuracy.4, 5 Neuroscience can make a significant contribution to help scrutinise the validity of Dual-Process Theory by examining if these two systems exist in different anatomical regions in the brain.
