Scripts and medical diagnostic knowledge: Theory and applications for clinical reasoning instruction and research

Medical diagnosis is a categorization task that allows physicians to make p redictions about features of clinical situations and to determine appropria te course of action. The script concept, which first arose in cognitive psy chology, provides a theoretical framework to explain how medical diagnostic knowledge can be structured for diagnostic problem solving. The main chara cteristics of the script concept are pre-stored knowledge, values acceptabl e or not acceptable for each illness attribute, and default values. Scripts are networks of knowledge adapted to goals of clinical tasks. The authors describe how scripts are used in diagnostic tasks, how the script concept f its within the clinical reasoning literature, how it contrasts with competi ng theories of clinical reasoning, how educators can help students build an d refine scripts, and how scripts can be used to assess clinical competence .