Problems of research into medical problem solving: some remarks on theory and method

Investigators of medical problem solving, and of problem solving in general, appear to use the term problem solving to denote different concepts. Medical problem solving sometimes refers to the doctor solving the patient's problem, whereas others use it to refer to the doctor solving his own diagnostic problem. Second, 'problem' is used by some in a subjective sense (something is only called a problem if the subject has difficulties with it), and by others in an objective sense (problem being nearly synonymous with task). Finally, there is the definitional question of whether knowledge and problem solving are regarded as independent or as intimately related. What one means by problem solving, with one's research objectives (research may be aimed at medical education, medical practice or cognitive theory), constitute the major determinants of the choice of research design. It is advocated that investigators, before selecting a research design, should clarify their own definitions and research objectives, and before adopting other investigators' definitions and research designs, should consider carefully their research objectives.