Nendaz M
Service de médecine interne générale, UDREM, hôpitaux universitaires, 1211 Genève 14, Suisse.
Rev Med Interne. 2011 Jul;32(7):436-42. doi: 10.1016/j.revmed.2010.12.005. Epub 2011 Jan 12.
A medical decision when facing a clinical problem is the result of a complex process involving clinical reasoning and decision-making components. Several biases and external factors may influence this process. Educational interventions may be helpful to modify some of those factors and enhance the quality of decision-making, such as the training of clinical reasoning, making physicians aware of potential biases, or training them to use some tools brought by the evidence-based medicine movement. However, the impact of such interventions remains difficult to quantify because high-quality data are lacking and few studies really assess patient outcomes. This article reviews the available evidence of interventions aiming at improving the quality of decision-making and stresses the importance of involving clinician teachers in medical education research.