Reviewing intuitive decision-making and uncertainty: the implications for medical education.

Full Abstract

CONTEXT:
Intuition and uncertainty are inescapable conditions of many instances of clinical decision- making. Under such conditions biases and heuristics may operate, distorting the decision-making process. Physicians and students are generally unaware of these influences.

PURPOSE:
To review the extant literature regarding the role of uncertainty and intuition and associated biases on medical decision-making, to highlight the implications this holds for medical education.

CONTENT:
Using literature identified via Medline and Bioethicsline searches of the past 3 decades, this paper reviews the sources of uncertainty in clinical practice and the role of intuitive decision-making. A detailed description of associated heuristics and biases is provided, and linked with demonstrable examples from medical decision-making.

CONCLUSIONS:
It is argued that although uncertainty can be reduced, it can never be completely eliminated from decision-making. Therefore most decision-making performed in medicine contains an irreducible intuitive element and is thus vulnerable to these biases and heuristics. Given that few medical curricula overtly address the process of medical decision-making, both medical students and physicians remain vulnerable to these effects on their own (and their patients') decision-making. Insight via education appears the major means in which to avoid distorting decision-making processes.

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Author information

Author/s: Hall, Katherine H (KH);

Affiliation: Department of General Practice, Dunedin School of Medicine, University of Otago, New Zealand. katherine.hall@chmeds.ac.nz

Journal and publication information

Publication Type: Journal Article; Review

Journal: Medical education (Med Educ), published in England. (Language: eng)

Reference: 2002-Mar; vol 36 (issue 3) : pp 216-24

Dates: Created 2002/03/06; Completed 2002/04/23; Revised 2004/11/17;

PMID: 11879511, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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