Reflective Practice and Leadership in Medicine and Medical Education Component 3: Formulation of Working Hypothesis/Diagnosis

Once satisfied with the description of the case and the potential factors at play, faculty help participants generate a dagnosis or working hypothesis that accounts for the features of the situation. In this method a diagnosis means more than a clear description of a pattern, or taxonomy. A diagnosis is seen as a hypothesis — a tentative explanation of the “causes or nature of a … situation” (see “diagnosis” in Merriam-Webster Online) that is subject to a test by an action. In this way a diagnosis/hypothesis logically suggests mechanisms of action and thus possible pathways for change.

Again, when the participants offer a diagnosis/hypothesis the faculty ask follow-up questions if the explanation does not include a clear link to the evidence and possible mechanisms of action (see section on Systemic Hypotheses: Biological and Social in Appendices for Educator Methods).