Can intuition be taught? YES
ezamir at UNIMELB.EDU.AU
Mon Aug 19 00:38:32 UTC 2013
Whether the skill of jumping over diagnostic hurdles is innate or learnt is a fascinating question. So is the question of to what extent we can teach it to our trainees. One big elephant in this room, from a patient-centered perspective, is whether we actually assess our trainees reliably for that skill. I believe that prior to becoming independent specialists, doctors should be assessed not only on their knowledge, as happens too often, but also on their diagnostic skills in real life situations (where there are often confounders, distracting factors, misleading previous information and inherent cognitive biases). While most educationalists would view this as "unfair" to the candidates, I believe it is unfair to patients not to do so.
Specialists should be able to demonstrate the skill of questioning a previous diagnosis when appropriate, rather than assume it is correct, the skill of confidently stating nothing is seriously wrong with a patient they examine (rather than refer to unnecessary tests), and the skill of keeping an open mind and not just focusing on the first and most obvious finding they find (search satisfaction). All of the above may be tested by clinical simulations, either with real patients in an exam or in a well-constructed (ideally incognito patient based) workplace assessment. While we should continue to try and understand what's in the diagnostic black box (intuition/ a well balanced Type 1 thinking and Type 2 thinking/ experience/ innate or acquired properties), we should also remember that whatever it is made of, specialists should be assessed and prove they have it, or at least an acceptable level of it.
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