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How do gut feelings feature in tutorial dialogues on diagnostic reasoning in GP traineeship?
C F Stolper1, M W J Van de Wiel, R H M Hendriks
1Department of General Practice, Faculty of Health, Medicine and Life Sciences, CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands, cf.stolper@maastrichtuniversity.nl.
Advances in Health Sciences Education : Theory and Practice
|September 5, 2014
Summary
General practitioners' (GPs) diagnostic reasoning involves analytical and non-analytical processes, including gut feelings. Tutorial dialogues show supervisors can effectively teach trainees to integrate gut feelings into analytical reasoning for better medical education.
Area of Science:
- Medical Education
- Cognitive Science in Medicine
- General Practice
Background:
- Diagnostic reasoning integrates analytical and non-analytical cognitive processes.
- Gut feelings, a form of non-analytical reasoning, significantly influence general practitioners' (GPs) diagnostic decisions.
- GP traineeships involve regular consultations with supervisors to discuss patient cases and enhance competencies.
Purpose of the Study:
- To examine how supervisors and trainees discuss diagnostic reasoning in tutorial dialogues.
- To investigate the role and integration of 'gut feelings' within these discussions.
- To assess the educational value of discussing non-analytical reasoning in medical training.
Main Methods:
- Analysis of 17 video-recorded and transcribed tutorial dialogues between GP supervisors and trainees.
- Utilized a detailed bottom-up, iterative content analysis and coding procedure.
- Segmented dialogues into quotes, coded for content and participant, with word count as a unit of analysis.
Main Results:
- Tutorial dialogues primarily focused on analytical reflections of trainees' diagnostic reasoning, often using hypothetico-deductive strategies.
- Gut feelings were discussed in seven dialogues, serving as a tool to induce analytical reflection on the diagnostic process.
- The emphasis in dialogues was predominantly on analytical aspects of reasoning.
Conclusions:
- Discussing gut feelings in tutorial dialogues is an effective method for familiarizing trainees with non-analytical reasoning.
- Supervisors require specialized knowledge to effectively address and teach non-analytical reasoning in medical education.
- Integrating discussions on gut feelings can enhance diagnostic reasoning training for general practice trainees.
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