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

1. Reviewing intuitive decision-making and
Reviewing intuitive decision-making and uncertainty:
the implications for medical education
Katherine H Hall
Medical Education 2002;36:216–224
Presenter: Jing Chunyan
Zhejiang University
Swallow.jing@163.com

2. Reviewing intuitive decision-making and
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.

3. Reviewing intuitive decision-making and
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.

4. Reviewing intuitive decision-making and
Introduction
Intuition is an inescapable part of decision-making
in medicine and involves personal decision rules of
physicians. Intuitive decision-making is more likely to
occur particularly under conditions of uncertainty.

5. Reviewing intuitive decision-making and
Sources of uncertainty in clinical practice
First order
uncertainty
Technical sources of uncertainty
It can be reduced and/or eliminated.
Second order
uncertainty
Personal sources of uncertainty
It always remain.
Conceptual sources of uncertainty
It always remain.

6. Reviewing intuitive decision-making and
Responses to uncertainty
Denial: It imposes a degree of clarity on what may otherwise be
a murky and confusing situation, and may make decision-
making easier through this illusion of control and mastery.
A tendency to uphold medical orthodoxy: the safest and most
comfortable position is to do what others are doing.
A preference for high technology specialties: disquiet with
uncertainty leads to an inappropriate love of technology in fully
trained doctors and medical students.

7. Reviewing intuitive decision-making and
Errors and biases in expert intuition
Physicians’ intuitive decisions made under conditions
of uncertainty are also prone to well-documented errors
and biases. They include representativeness, availability,
adjustment and anchoring , hindsight bias, framing effect
bias , optimistic bias, value bias, informational bias,
sociocultural bias , and so on.

8. Reviewing intuitive decision-making and
Implications for medical education
The implications of this evidence need to be integrated
within medical curricula in the training of both
undergraduate and postgraduate doctors. Education of
medical students about the role of uncertainty and these
biases can give them insight into their decision-making.

9. Reviewing intuitive decision-making and
Further research
Further research is also needed in developing strategies
that ameliorate other types of biases and also in exploring
the extent these biases affect decision-making in medical
ethics.

10. Reviewing intuitive decision-making and
Thanks