Would podiatrists benefit from an expert system for clinical reasoning and diagnosis?: A study using laddering

Abstract

Background Computer expert systems may be of benefit to podiatrists in assisting in diagnosis. However little is known about how podiatrists use certain forms of clinical reasoning in making a diagnosis. Objectives To investigate the mechanisms used by podiatrists in the process of clinical reasoning and whether a computer expert system may aid the process of diagnosis. Method Laddering was used on a random sample of 12 podiatrists to find why podiatrists use certain mechanisms of clinical reasoning to make a diagnosis. Each podiatrist was interviewed by telephone and the information recorded to audio tape. A content analysis of the laddering data produced a hierarchical value map for clinical reasoning. Results The hierarchical value map suggested that the podiatrists rely on tacit knowledge and highly schematized knowledge for their clinical decision making. It was concluded that a computer expert system is not the best technology for clinical decision making in this context.