Year-end Sale % OFF 
Abstract
Dual-process theories may be invoked to explain how physicians interact with, interpret, and draw inferences from clinical information. Stanovich and West’s model articulates two kinds of thinking—intuitive-based System 1 and analytical-based System 2—which have been under-investigated with physicians in training. This qualitative study explored pre-clerkship medical students’ retrospective perspectives and experiences of System 1 and System 2 thinking via 12 semi-structured interviews and abductive, progressive focusing. Participants identified patient interactions, clinical note writing, knowledge synthesis, problem list and differential diagnosis generation, evaluating evidence, and critical appraisal of literature as pre-clerkship opportunities to engage in System 1 or System 2 thinking. Six major themes emerged from analysis of participants’ interview transcripts: cognitive processes, deliberate practice, learning environment: being alone or being together, stickiness factor, biases and heuristics, and prior experience of attaining competence. Participants valued the anticipated role that System 1 and System 2 thinking will play in their future practice, and experienced nascent, self-regulated development of these cognitive processes during the pre-clerkship phase of their education without formal feedback or coaching from clinician preceptors. Pre-clerkship curricula should further embrace low-stakes, incremental teaching on metacognition and continuous monitoring of knowledge processing as a key competency for physician learners.
Highlights
Clinical reasoning is a consequential competency routinely exercised by almost all physicians irrespective of their specialty [1]
System 1 is an effortless process that drives intuitive, heuristic thinking on the basis of pattern recognition and mental schemas that have accumulated over time [8,9]
Practice, and experience, cognitively demanding tasks become automatic as slow, serial processing is replaced by pattern recognition and the fast, associative thinking that is authentic to expertise and proficiency
Summary
Clinical reasoning is a consequential competency routinely exercised by almost all physicians irrespective of their specialty [1]. The propriety of physicians reasoning and making decisions using either System 1 or System 2 warrants consideration of the complexity and urgency of the prevailing clinical context and task, the physician’s prior experience with similar circumstances and their outcomes, as well as their emotional state, and competence and self-confidence in their own metacognitive abilities [17]. To this end, the dual-process theory model holds that experts who possess adaptive mastery can transition readily to and from System 1 and System 2 thinking [1]. Quirk (2006) has stated, “Taken together, Systems 1 and 2 processing promotes greater efficiency in thinking, decision-making and action and help bring order to chaos and uncertainty.” [18]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
