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Systems 1 and 2 thinking processes and cognitive reflection testing in medical students.

Shu Wen Tay1, Paul Ryan2, C Anthony Ryan1

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Medical students utilize both intuitive (System 1) and analytical (System 2) thinking. The Cognitive Reflection Test revealed that up to half of students relied on intuitive responses, highlighting the need for metacognitive awareness in clinical practice.

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Area of Science:

  • Cognitive Psychology
  • Medical Education

Background:

  • Diagnostic decision-making integrates intuitive (System 1) and analytical (System 2) thinking.
  • Understanding the balance of these cognitive systems is crucial in medical training.

Purpose of the Study:

  • To evaluate and compare System 1 and System 2 thinking levels in pre-clinical and clinical medical students.
  • To assess the utility of the Cognitive Reflection Test (CRT) in this evaluation.

Main Methods:

  • Administered the three-question Cognitive Reflection Test (CRT) to medical students.
  • Categorized responses based on intuitive (System 1) and analytical (System 2) thinking.
  • Compared CRT performance between pre-clinical (Years 2-3) and clinical (Year 4) students.

Main Results:

  • 44% of students answered all CRT questions correctly, indicating strong System 2 thinking.
  • 10% of students consistently chose intuitive answers (System 1).
  • CRT performance improved across questions, with fewer intuitive answers as students progressed.

Conclusions:

  • A significant portion of medical students exhibit reliance on intuitive thinking (System 1).
  • The CRT can aid students in recognizing the importance of metacognitive regulation in clinical practice.
  • Further research is needed to correlate CRT performance with future clinical expertise.