Clinical Decision Making

  • Pat CroskerryEmail author


In every domain of medicine, decisions are continuously being made about patients’ diagnosis and management. Arguably, decision making is the most important aspect of a patient’s care and the most likely to affect their safety, yet physicians generally do not receive comprehensive training in this basic skill. In this chapter, dual process theory, the dominant model of clinical decision making, is reviewed. The two basic modes of decision making are intuitive and analytical. The properties of the two systems are discussed, as is their dynamic relationship with each other in the operating characteristics of the model.

Many of the requirements for improving decision making can be found in the burgeoning literature on critical thinking. Significant gains in decision making skills can be made by teaching the basics of decision making within a critical-thinking framework and by thoroughly understanding the nature and extent of cognitive and affective biases and how to mitigate them. There remains an overarching need for research in clinical decision making that is relevant to the clinical settings and conditions under which decisions are made.


Clinical decision making Dual process theory Cognitive and affective bias Cognitive de-biasing Critical thinking 


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Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  1. 1.Critical Thinking Program, Division of Medical Education, Faculty of Medicine, Department of Emergency Medicine, QE – Health Sciences Centre, Halifax InfirmaryDalhousie UniversityHalifaxCanada

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