Reviewing intuitive decision-making and uncertainty: the implications for medical education
Version of Record online: 5 MAR 2002
Volume 36, Issue 3, pages 216–224, March 2002
How to Cite
Hall, K. H. (2002), Reviewing intuitive decision-making and uncertainty: the implications for medical education. Medical Education, 36: 216–224. doi: 10.1046/j.1365-2923.2002.01140.x
- Issue online: 5 MAR 2002
- Version of Record online: 5 MAR 2002
- Received 14 January 2001; editorial comments to authors 29 March 2001; accepted for publication 10 May 2001
- Education, medical/*standards;
- *decision making;
- professional practice;
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.
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.
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.
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.