Social Judgement Theory and Medical Judgement

Abstract

Social judgement theory is particularly well suited to the study of medical judgements. Medical judgements characteristically involve decision making under uncertainty with inevitable error and an abundance of fallible cues. In medicine, as in other areas, SJT research has found wide variation among decision makers in their judgements and in the weighting of clinical information. Strategies inferred from case vignettes differ from physicians' self-described strategies and from the weights suggested by experts. These observations parallel recent findings of unexplained variation in diagnosis and management in clinical practice that have been the source of concern in the medical community. The lens model provides one of the few methods for quantitatively analysing physicians' judgements. Contrary to what one might expect from the variation in strategies on paper cases, several studies suggest that, in practice, physicians' diagnostic judgements are highly accurate. Cognitive feedback has been less successful as a practical teaching tool than originally hoped, but some aspects of this methodology show promise, particularly in conjunction with the increasing emphasis on statistical decision support. All things considered, SJT has provided insight into physicians' decisions and gives the medical research community important tools for studying judgements in actual practice.