A Correct Diagnosis is of Increasing Importance All clinicians are aware of the importance of reaching the correct diagnosis. It is impressed on every medical student and trainee from the outset.
This article has been cited by other articles in PMC. Abstract Context Clinical reasoning plays a major role in the ability of doctors to make diagnoses and decisions.
Since the s, many theories about clinical reasoning in medicine have been put forward. Purpose This paper aims at exploring a comprehensive approach: Discussion After 40 years of sometimes contradictory studies on clinical reasoning, the dual-process theory gives us many answers on how doctors think while making diagnoses and decisions.
However, it has not received much attention in the medical education literature. The implications of dual-process models of reasoning in terms of medical education will be discussed. It allows physicians to make diagnoses and decisions e. Many researchers — including health professionals, education specialists, cognitive psychologists and sociologists — have therefore invested this field of medical practice and education for nearly 40 years.
Their work has helped many to understand clinical reasoning as an idiosyncratic, multifaceted and highly complex skill, characterized by different processes that mobilize specific knowledge held in long-term memory 34. However, many researchers still have diverging opinions on how doctors think while making diagnoses and decisions, particularly on the place of intuition in the reasoning process and its interactions with analytic thinking.
This article aims at casting a comprehensive view on clinical reasoning, through a model developed over the past 15 years: This model of reasoning has been previously described in the cognitive psychology literature, but remains uncommonly used in the medical education literature.
Our aim is to provide a review of the major works done over recent years on the dual-process theory, in order to make this approach more available to clinical teachers and medical educators. First we take a look at a description of this contemporary theory, in the context of reasoning in general.
We then describe how it relates to the models of reasoning that have been identified in the field of medicine. Finally, we discuss the implications of this approach for medical education and define new challenging research topics related to the dual-process models of clinical reasoning.
Two separate systems According to this approach, two cognitive systems are used to reason.
It produces an intuitive response, which means that it is generated without effort and is below the threshold of perceptible consciousness 8. The intuitive system is therefore particularly rapid 9. It uses information which is readily available, in particular visual, and operates on the principle of recognition of a typical configuration of signs, or of similarities with previously encountered similar situations.
The approach of the clinician is at once partial only part of the available information is processedholistic the individual will make an overall assessment of the situation and approximate 7. The response that is generated intuitively is highly dependent on contextual cues, as we will see later In addition, the affective state of the individual is an important determinant of intuitive reasoning 9 — It comes from a rational and deliberate judgement based on additional information collected actively by the individual in his or her environment and the conscious application of rules that have been acquired through learning 9 — 11 It is therefore rather slow and very demanding for cognition The place of intuition in the reasoning process Bargh and Chartrand 15 state that the majority of our decisions and actions are the result of automated reasoning.
In the same vein, Kahneman 9 considers that in our daily life it is the most common path of decision-making. According to other authors, such as Epstein 5Hogarth 78 and Hammond 6the two systems are jointly involved in most of our cognitive activities. Depending on the situation, the individual would rather use the intuitive system or the analytical system.
Situations in which the valence goes towards one system or another remain unclear. Preliminary conclusions from recent publications in the medical literature tend to show that the valence goes towards the analytical system in the following situations 14 In contrast, routine problems associated with a higher level of certainty would be more often dealt with by the intuitive system, especially when time is lacking.
From a functional point of view, in the hypothesis that both systems are jointly involved in most of our decisions, reasoning always starts intuitively, which means that environmental information is interpreted preconsciously at first 8.
The intuitive system is activated unconsciously and automatically 78. As a general rule, the result of this automated processing will give rise in the working memory to the genesis of one or more possible solutions.
Prompting the analytical system will then allow confirmation or invalidation of the relevance of these 8. However, in some situations actions can be undertaken automatically and thus can come before the understanding the subject has of the situation, in order to allow a prompt intervention 8 The monitoring function of the analytical system over the intuitive system Kahneman and Klein 17 reviewed some experiments showing that individuals often adopt the intuitive response without checking it.
They give priority to rapidly generated solutions rather than deep analytic thinking. Yet, theoretically, the analytical system plays a monitoring role over the intuitive response.
It can consciously overrule the intuitive process in situations where a conflict in believability or validity is detected 9is that they know that critical thinking is contextualit changes, depending on cir-cumstances.
Sometimes intuitive thinking is more appropriate than logical thinking, and vice versa. For example, brain storming sessions are a great time to nurture intuition, because logical .
Inductive reasoning is the reverse, making generalizations based on specific facts. The conclusion here is based on existing information, and does not depend on special knowledge. The terms are not ambiguous, which would imply they are unclear or open to various interpretations.
The Importance of Intuition for Your Health. by Dr. Doni. Dr. Doni explains new research about the importance of patients’ intuition when it comes to their health outcomes – and how this informs her approach to wellness.
Intuition is the ability to understand immediately, without reasoning. and is methodical and analytical, whereas intuition relies more on a practitioner’s perception.
Intuition is an unconscious process The NHS places great importance on evidence-based This article will consider hypothetico-deductive reasoning and intuition when making clinical decisions in practice.
Intuitive decision making has been found in some cases to improve decisions 4–6 and lead consistently to better performance than analytic deliberation. 7–9 The clinical literature nevertheless warns doctors against intuition to avoid reasoning errors and cognitive biases.
10–13 Much of this literature is opinion-based and attempts to apply . Mar 14, · The place of intuition and analytical thinking in the clinical reasoning process, and the interactions between the two systems. It has been widely accepted for over a decade that the analytical and non-analytical processes identified within the scope of clinical reasoning research are not mutually exclusive (32–34).