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Licensed Unlicensed Requires Authentication Published by De Gruyter September 20, 2021

Narrowing the mindware gap in medicine

  • Pat Croskerry EMAIL logo
From the journal Diagnosis


Medical error is now recognized as one of the leading causes of death in the United States. Of the medical errors, diagnostic failure appears to be the dominant contributor, failing in a significant number of cases, and associated with a high degree of morbidity and mortality. One of the significant contributors to diagnostic failure is the cognitive performance of the provider, how they think and decide about the process of diagnosis. This thinking deficit in clinical reasoning, referred to as a mindware gap, deserves the attention of medical educators. A variety of specific approaches are outlined here that have the potential to close the gap.

Corresponding author: Pat Croskerry, Emergency Medicine, Dalhousie University, Halifax, Canada, E-mail:

  1. Research funding: None declared.

  2. Author contributions: I am the sole author and accept responsibility for the entire content of this manuscript and approve its submission.

  3. Competing interests: None declared.

  4. Informed consent: Not applicable.

  5. Ethical approval: Not applicable.


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Received: 2020-10-10
Accepted: 2021-08-23
Published Online: 2021-09-20

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