Module 4

How did the readings influence your perception of your own clinical decision-making?

Kahneman (2008) describes the ‘Mode of Thinking’ involving two systems. The first system is described as intuition involving an automatic response. It is hard to control, a slow learner, associative, and easily jumps to conclusions. The second system, reasoning, results in a slower execution, requiring both control and effort. If the second system cannot monitor the intuitive or automatic system, performance changes.

‘Cognitive Dispositions to Respond’, also known as heuristics and biases, may impact clinical decision-making. One must examine what decisions are based upon, whether it is experience or evidence and in what combination. The logic or rationality behind a decision may be influenced by level of certainty or uncertainty, as well as values and beliefs. Use of computer systems may result in consistent performance not influenced by values or beliefs, and not affected by fatigue and distractions. Of course, the data has to have integrity.

Electronic medical resources (EMR) and health records provide clinical decision support interventions to guide and support the clinical user in establishing next steps, offering useful evidence-based knowledge, and providing relevant patient information in making an accurate diagnosis. The data collected from the EMR must be accurate if it is to be used in clinical decision-making. Multiple resources are required to design, maintain and monitor effectiveness of data within the electronic medical resources. Without electronic record sharing within the health care delivery system, this type of tool have not yet completely realized or utilized.


Kahneman, D. (2008, January 31). Explorations of the mind: Intuition [Video file]. Retrieved from http://www.youtube.com/watch?v=dddFfRaBPqg