Measuring Doctors' Self-insight into their Treatment Decisions

We report two studies here. Both focus on the nature and measurement of self-knowledge in judgement making. In the first study we asked 32 British family physicians (GPs) to identify their own policy from sets of policies describing their own and their contemporaries' prescription behaviour. They were no better at identifying their own stated policies than the policies we had statistically generated to describe their behaviour. In the second study we measured the information 30 GPs selected while making judgements about prescription. Patterns of information selection were similar to the way the GPs rated the influence of the information but dissimilar to the pattern of information use as measured in a judgement analysis. The pattern of results in both studies is consistent with the possibility that the knowledge GPs have is of the extent to which they attend to information. Copyright © 2000 John Wiley & Sons, Ltd.

[1]  M. Doherty,et al.  A social judgment theoretic approach to sex discrimination in faculty salaries , 1978 .

[2]  J. Shanteau Competence in experts: The role of task characteristics , 1992 .

[3]  Paul Slovic,et al.  Comparison of Bayesian and Regression Approaches to the Study of Information Processing in Judgment. , 1971 .

[4]  Robert S. Wigton,et al.  Social Judgement Theory and Medical Judgement , 1996 .

[5]  M. Rothert Physicians' and Patients' Judgments of Compliance with a Hypertensive Regimen , 1982, Medical decision making : an international journal of the Society for Medical Decision Making.

[6]  Patrick H. Raymark,et al.  The Many Meanings of Religiousness: A Policy‐Capturing Approach , 1995 .

[7]  Michael E. Doherty,et al.  Judgment theory applied to the selection of life insurance salesmen , 1976 .

[8]  K. A. Ericsson,et al.  Verbal reports as data. , 1980 .

[9]  R. Pliske,et al.  The many faces of hyperactivity: similarities and differences in diagnostic policies. , 1981, Journal of consulting and clinical psychology.

[10]  P. Hoffman The paramorphic representation of clinical judgment. , 1960, Psychological bulletin.

[11]  L. Hattersley,et al.  Antibiotics for otitis media: can we help doctors agree? , 1985, Family practice.

[12]  A S Elstein,et al.  Hormonal Replacement Therapy , 1992, Medical decision making : an international journal of the Society for Medical Decision Making.

[13]  W. Estes The cognitive side of probability learning. , 1976 .

[14]  Leslie B. Hammer,et al.  Task information, cognitive information, or functional validity information: Which components of cognitive feedback affect performance?☆ , 1992 .

[15]  Ray W. Cooksey,et al.  Judgment analysis : theory, methods, and applications , 1996 .

[16]  K. R. Hammond,et al.  An Experimental Study of the Clinical Judgment of General Physicians in Evaluating and Prescribing for Depression , 1981, British Journal of Psychiatry.

[17]  Dianne C. Berry,et al.  Implicit Learning , 1993 .

[18]  G. Gigerenzer,et al.  Probabilistic mental models: a Brunswikian theory of confidence. , 1991, Psychological review.

[19]  Michael L. Maynard,et al.  Using judgment analysis to improve consultant/client understanding: An advertising application , 1996 .

[20]  T. R. Stewart,et al.  The Importance of the Task in Analyzing Expert Judgment , 1997 .

[21]  K. A. Ericsson,et al.  Protocol Analysis: Verbal Reports as Data , 1984 .

[22]  C. Harries,et al.  General practitioners' tacit and stated policies in the prescription of lipid lowering agents. , 1995, The British journal of general practice : the journal of the Royal College of General Practitioners.

[23]  J. Kirwan,et al.  How can we design trials to detect clinically important changes in disease severity? , 1988, British journal of clinical pharmacology.

[24]  A S Elstein,et al.  Differences in Medical Referral Decisions for Obesity Among Family Practitioners, General Internists, and Gynecologists , 1984, Medical care.

[25]  J Grant,et al.  The structure of memorized knowledge in students and clinicians: an explanation for diagnostic expertise , 1987, Medical education.

[26]  M. Rothert,et al.  Physicians' Judgments About Estrogen Replacement Therapy for Menopausal Women , 1984, Obstetrics and gynecology.

[27]  Michael E. Doherty,et al.  The assessment of self-insight in judgment policies , 1992 .

[28]  Jonathan Evans,et al.  Rationality and reasoning , 1996 .

[29]  R. Hogarth,et al.  Confidence in judgment: Persistence of the illusion of validity. , 1978 .

[30]  D. A. Summers,et al.  Subjective vs objective description of judgment policy , 1970 .

[31]  R. Green,et al.  Judging Relative Importance: Direct Rating and Point Allocation Are Not Equivalent , 1997, Organizational behavior and human decision processes.

[32]  Michael E. Doherty,et al.  A note on the assessment of self-insight in judgment research , 1989 .

[33]  Thomas R. Stewart,et al.  A comparison of seven methods for obtaining subjective descriptions of judgmental policy , 1975 .

[34]  Timothy D. Wilson,et al.  Telling more than we can know: Verbal reports on mental processes. , 1977 .

[35]  C. Harries Judgement Analysis of Patient Management: General Practitioners' Policies and Self-Insight. , 1995 .

[36]  R. Darlington,et al.  Multiple regression in psychological research and practice. , 1968, Psychological bulletin.

[37]  R S Wigton,et al.  Use of Linear Models to Analyze Physicians' Decisions , 1988, Medical decision making : an international journal of the Society for Medical Decision Making.

[38]  G. A. Miller,et al.  Book Review Nisbett, R. , & Ross, L.Human inference: Strategies and shortcomings of social judgment.Englewood Cliffs, N.J.: Prentice-Hall, 1980. , 1982 .

[39]  R. Wigton,et al.  A Social Judgment Theory Perspective On Clinical Problem Solving , 1990 .

[40]  L. Hasher,et al.  Automatic and effortful processes in memory. , 1979 .

[41]  C. Joyce,et al.  Inability of rheumatologists to describe their true policies for assessing rheumatoid arthritis. , 1986, Annals of the rheumatic diseases.

[42]  T. R. Stewart,et al.  Increasing the Power of Clinical Trials Through Judgment Analysis , 1988, Medical decision making : an international journal of the Society for Medical Decision Making.

[43]  D. Shanks,et al.  Characteristics of dissociable human learning systems , 1994, Behavioral and Brain Sciences.

[44]  Self-insight, Other-insight, and Their Relation to Interpersonal Conflict , 1996 .