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GP Vivascore-skills

GP Vivas · core-skills

Clinical reasoning, bias, and diagnostic uncertainty — structured viva

Structured oral on clinical reasoning: defending dual-process theory, naming the biases that cause diagnostic error, using gut feelings with evidence, safety-netting structure, and cognitive forcing strategies.

structured clinical oral2 min readVerification in progress

Target exams

RACGP CCEFRACGP oralsMRCGP SCA
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Study tools

Target exams

RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'Experienced doctors don't make diagnostic errors — they have seen it all before.' You are asked to present the evidence against this claim.

Stem

A senior colleague claims that diagnostic errors only happen to inexperienced doctors. You are asked to present the evidence. [1]

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You have read the opening of this viva. The complete unit — every section and its primary-source references — is part of the General Practice fellowship library.

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References5ShowHide
  1. [1]Croskerry P Cognitive forcing strategies in clinical decisionmaking. Ann Emerg Med, 2003.PMID 12514691
  2. [2]Croskerry P, Singhal G, Mamede S Cognitive debiasing 2: impediments to and strategies for change. BMJ Qual Saf, 2013.PMID 23996094
  3. [3]Smith CF, Drew S, Ziebland S, Nicholson BD Understanding the role of GPs' gut feelings in diagnosing cancer in primary care: a systematic review and meta-analysis of existing evidence. Br J Gen Pract, 2020.PMID 32839162
  4. [4]Robles LA, Abel GA, Black GB, Hamilton W, King A, et al. 'One of the hardest things in medicine is challenging an initial diagnosis': interim diagnoses and missed opportunities for diagnosing cancer in primary care, a qualitative study. Br J Gen Pract, 2026.PMID 41991222
  5. [5]Al Essa A, Schmidt HG, Mamede S, Knežević K, Zwaan L, Magzoub M Premature closure underlies bias in medical diagnosis in students: A randomised controlled experiment. Med Educ, 2026.PMID 42051011
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