How do gut feelings feature in tutorial dialogues on diagnostic reasoning in GP traineeship?

Advances in Health Sciences Education

Volumn 20, Issue 2, 2014, Pages 499-513

  Stolper, C F ^a,b   Van de Wiel, M W J ^a   Hendriks, R H M ^a   Van Royen, P ^b   Van Bokhoven, M A ^a   Van der Weijden, T ^a   Dinant, G J ^a  

^a MAASTRICHT UNIVERSITY   (Netherlands)

^b UNIVERSITY OF ANTWERP   (Belgium)

Author keywords

Diagnostic reasoning; GP vocational training; Gut feelings; Intuition; Non analytical reasoning; Tutorial dialogues

Indexed keywords

CLINICAL COMPETENCE; CLINICAL DECISION MAKING; EDUCATION; EMOTION; FEMALE; GENERAL PRACTITIONER; HUMAN; INTERPERSONAL COMMUNICATION; MALE; MEDICAL EDUCATION; NETHERLANDS; PROCEDURES;

CLINICAL COMPETENCE; CLINICAL DECISION-MAKING; COMMUNICATION; EMOTIONS; FEMALE; GENERAL PRACTITIONERS; HUMANS; INTERNSHIP AND RESIDENCY; MALE; NETHERLANDS;

EID: 85016500678     PISSN: 13824996     EISSN: 15731677     Source Type: Journal    
DOI: 10.1007/s10459-014-9543-3     Document Type: Article

References (49)

1. Ark, T. K., Brooks, L. R., & Eva, K. W. (2007). The benefits of flexibility: The pedagogical value of instructions to adopt multifaceted diagnostic reasoning strategies. Medical Education,41, 281–287.
2. Boreham, N. C. (1994). The dangerous practice of thinking. Medical Education,28, 172–179.
3. Buntinx, F., Truyen, J., Embrechts, P., Moreel, G., & Peeters, R. (1991). Chest pain: An evaluation of the initial diagnosis made by 25 Flemish general practitioners. Family Practice,8, 121–124.
4. Chi, T. H. M. (1997). Quantifying qualitative analyses of verbal data: A practical guide. The Journal of the Learning Sciences,6, 271–315.
5. Chi, M. T., Roy, M., & Hausmann, R. G. (2008). Observing tutorial dialogues collaboratively: Insights about human tutoring effectiveness from vicarious learning. Cognitive Science,32, 301–341.
6. Coderre, S., Mandin, H., Harasym, P. H., & Fick, G. H. (2003). Diagnostic reasoning strategies and diagnostic success. Medical Education,37, 695–703.
7. Coderre, S., Wright, B., & McLaughlin, K. (2010). To think is good: Querying an initial hypothesis reduces diagnostic error in medical students. Academic Medicine,85, 1125–1129.
8. Davey, J., Turner, R. M., Clarke, M. J., & Higgins, J. P. (2011). Characteristics of meta-analyses and their component studies in the Cochrane Database of Systematic Reviews: A cross-sectional, descriptive analysis. BMC Medical Research Methodology,11, 160.
9. Elstein, A. S. (2009). Thinking about diagnostic thinking: A 30-year perspective. Advances in Health Sciences Education Theory Practice,14(Suppl 1), 7–18.
10. Elstein, A. S., & Schwarz, A. (2002). Clinical problem solving and diagnostic decision making: A selective review of the cognitive literature. BMJ,324, 729–732.
11. Epstein, S. (1994). Integration of the cognitive and the psychodynamic unconscious. American Psychologist,49, 709–724.
12. Ericsson, K. A. (2004). Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Academic Medicine,79, S70–S81.
13. Eva, K. W. (2005). What every teacher needs to know about clinical reasoning. Medical Education,39, 98–106.
14. Eva, K. W., Hatala, R. M., Leblanc, V. R., & Brooks, L. R. (2007). Teaching from the clinical reasoning literature: Combined reasoning strategies help novice diagnosticians overcome misleading information. Medical Education,41, 1152–1158.
15. Evans, J. S. B. T., & Frankish, K. (2009). In two minds. Dual processes and beyond. Oxford: Oxford University Press.
16. Ferreira, M. B., Garcia-Marques, L., Sherman, S. J., & Sherman, J. W. (2006). Automatic and controlled components of judgment and decision making. Journal of Personality and Social Psychology,91, 797–813.
17. Finucane, M., Peters, E., & Slovic, P. (2003). Judgement and decision making: The dance of affect and reason. In S. L. Schneider & J. Shanteau (Eds.), Emerging perspectives on judgement and decision research (pp. 327–364). Cambridge: Cambridge University Press.
18. Graber, M. L., Kissam, S., Payne, V. L., Meyer, A. N., Sorensen, A., Lenfestey, N., et al. (2012). Cognitive interventions to reduce diagnostic error: A narrative review. BMJ Quality & Safety,21, 535–557.
19. Hamm, R. M. (1988). Clinical intuition and clinical analysis: Expertise and the cognitive continuum. In J. Dowie & A. Elstein (Eds.), Professional judgement. A reader in clinical decision making (pp. 78–104). Cambridge: Cambridge University Press.
20. Hobus, P. P., Schmidt, H. G., Boshuizen, H. P., & Patel, V. L. (1987). Contextual factors in the activation of first diagnostic hypotheses: Expert-novice differences. Medical Education,21, 471–476.
21. Hogarth, R. M. (2001). Educating intuition. Chicago: The University of Chicago Press.
22. Hogarth, R. M. (2010). Intuition: A challenge for psychological research on decision making. Psychological Inquiry,21, 338–353.
23. Johansen, M. L., Holtedahl, K. A., & Rudebeck, C. E. (2012). How does the thought of cancer arise in a general practice consultation? Interviews with GPs. Scandinavian Journal of Primary Health Care,30, 135–140.
24. Kahneman, D., & Frederick, S. (2005). A model of heuristic judgement. In K. J. Holyoak & R. Morrison (Eds.), The Cambridge handbook of thinking and reasoning (pp. 267–293). New York: Cambridge University Press.
25. Kahneman, D., & Klein, G. (2009). Conditions for intuitive expertise: A failure to disagree. American Psychologist,64, 515–526.
26. Klein, G. (2003). Intuition at work. New York: Doubleday.
27. Klein, G. (2009). Streetlights and shadows. Searching for the keys to adaptive decision making. Cambridge/London: Massachusetts Institute of Technology.
28. Krippendorff, K. (2012). Content analysis (3rd ed.). Newsbury Park, CA: Sage.
29. Lykke, K., Christensen, P., & Reventlow, S. (2008). “This is not normal… “—Signs that make the GP question the child’s well-being. Family Practice,25, 146–153.
30. Mamede, S., Schmidt, H. G., & Penaforte, J. C. (2008). Effects of reflective practice on the accuracy of medical diagnoses. Medical Education,42, 468–475.
31. Mamede, S., van Gog, T., Moura, A. S., de Faria, R. M., Peixoto, J. M., Rikers, R. M., et al. (2012). Reflection as a strategy to foster medical students’ acquisition of diagnostic competence. Medical Education,46, 464–472.
32. Mamede, S., van Gog, T., van den Berge, K., Rikers, R. M., van Saase, J. L., van Guldener, C., et al. (2010). Effect of availability bias and reflective reasoning on diagnostic accuracy among internal medicine residents. JAMA,304, 1198–1203.
33. Moulton, C. A., Regehr, G., Mylopoulos, M., & MacRae, H. M. (2007). Slowing down when you should: A new model of expert judgment. Academic Medicine,82, S109–S116.
34. Neuendorf, K. A. (2002). The content analysis guidebook. Thousands Oaks, CA: Sage.
35. Norman, G. R., Eva, K., Brooks, L. R., & Hamstra, S. (2006). Expertise in medicine and surgery. In K. A. Ericsson, N. Charness, P. J. Feltovich, & R. R. Hoffman (Eds.), The Cambridge handbook of expertise and expert performance (pp. 339–354). New York: Cambridge University Press.
36. Patel, V. L., Arocha, J. F., & Kaufman, D. R. (1999). Expertise and tacit knowledge in medicine. In R. J. Sternberg & J. A. Horvath (Eds.), Tacit knowledge in professional practice: Researcher and practitioner perspectives (pp. 75–120). Mahwah, NJ: Lawrence Erlbaum.
37. Slotnick, H. B. (1996). How doctors learn: The role of clinical problems across the medical school-to-practice continuum. Academic Medicine,71, 28–34.
38. Slotnick, H. B. (1999). How doctors learn: Physicians’ self-directed learning episodes. Academic Medicine,74, 1106–1117.
39. Slovic, P., Finucane, M., Peters, E., & MacGregor, D. G. (2002). The affect heuristic. In T. Gilovich, D. Griffin, & D. Kahneman (Eds.), Heuristics and biases (pp. 397–420). New York: Cambridge University Press.
40. Stolper, C. F. (2010). Gut feelings in general practice. Maastricht University, CAPHRI School for Public Health and Primary Care.
41. Stolper, C. F., Legemaate, J., & Dinant, G. J. (2010a). How do disciplinary tribunals judge the ‘gut feelings’ of doctors? An analysis of Dutch tribunal decisions 2000–2008. Journal of Law and Medicine,18, 68–75.
42. Stolper, C. F., Van Bokhoven, M. A., Houben, P. H. H., Van Royen, P., Van de Wiel, M., Van der Weijden, T., et al. (2009a). The diagnostic role of gut feelings in general practice. A focus group study of the concept and its determinants. BMC Family Practice,10, 17.
43. Stolper, C. F., Van de Wiel, M., Van Royen, P., Van Bokhoven, M. A., Van der Weijden, T., & Dinant, G. J. (2011). Gut feelings as a third track in general practitioners’ diagnostic reasoning. Journal of General Internal Medicine,26, 197–203.
44. Stolper, C. F., Van Royen, P., & Dinant, G. J. (2010b). The ‘sense of alarm’ (‘gut feeling’) in clinical practice. A survey among European general practitioners on recognition and expression. European Journal of General Practice,16, 72–74.
45. Stolper, C. F., Van Royen, P., Van Bokhoven, M. A., Houben, P. H. H., Van de Wiel, M., Van der Weijden, T., et al. (2009b). Consensus on gut feelings in general practice. BMC Family Practice,2009(10), 66.
46. Van de Wiel, M. W. J., Van den Bossche, P., Janssen, S., & Jossberger, H. (2011). Exploring deliberate practice in medicine: How do physicians learn in the workplace? Advances in Health Sciences Education Theory Practice,16, 81–95.
47. Van den Bruel, A., Aertgeerts, B., Bruyninckx, R., Aerts, M., & Buntinx, F. (2007). Signs and symptoms for diagnosis of serious infections in children: A prospective study in primary care. British Journal of General Practice,57, 538–546.
48. Van den Bruel, A., Haj-Hassan, T., Thompson, M., Buntinx, F., & Mant, D. (2010). Diagnostic value of clinical features at presentation to identify serious infection in children in developed countries: A systematic review. Lancet,375, 834–845.
49. Vanlehn, K., Graesser, A. C., Jackson, G. T., Jordan, P., Olney, A., & Rose, C. P. (2007). When are tutorial dialogues more effective than reading? Cognitive Science,31, 3–62.