Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Emerg Med J. 2012 Oct;29(10):811-6. doi: 10.1136/emermed-2011-200468. Epub 2011 Nov 7.
Dual-process psychological theories argue that clinical decision making is achieved through a combination of experiential (fast and intuitive) and rational (slower and systematic) cognitive processes.
To determine whether emergency physicians perceived their clinical decisions in general to be more experiential or rational and how this compared with other physicians.
A validated psychometric tool, the Rational Experiential Inventory (REI-40), was sent through postal mail to all emergency physicians registered with the College of Physicians and Surgeons of Ontario, according to their website in November 2009. Forty statements were ranked on a Likert scale from 1 (Definitely False) to 5 (Definitely True). An initial survey was sent out, followed by reminder cards and a second survey to non-respondents. Analysis included descriptive statistics, Student t tests, analysis of variance and comparison of mean scores with those of cardiologists from New Zealand.
The response rate in this study was 46.9% (434/925). The respondents' median age was 41-50 years; they were mostly men (72.6%) and most had more than 10 years of clinical experience (66.8%). The mean REI-40 rational scores were higher than the experiential scores (3.93/5 (SD 0.35) vs 3.33/5 (SD 0.49), p<0.0001), similar to the mean scores of cardiologists from New Zealand (mean rational 3.93/5, mean experiential 3.05/5). The mean experiential scores were significantly higher for female respondents than for male respondents (3.40/5 (SD 0.49) vs 3.30/5 (SD 0.48), p=0.003).
Overall, emergency physicians favoured rational decision making rather than experiential decision making; however, female emergency physicians had higher experiential scores than male emergency physicians. This has important implications for future knowledge translation and decision support efforts among emergency physicians.
双过程心理理论认为，临床决策是通过经验（快速和直观）和理性（较慢和系统）认知过程的结合来实现的。
确定急诊医师是否普遍认为他们的临床决策更多地是基于经验还是理性，以及这与其他医师的比较情况。
2009 年 11 月，根据安大略省医师和外科医生学院的网站，通过邮寄方式向所有注册的急诊医师发送了经过验证的心理计量工具，即理性经验量表（REI-40）。40 个陈述按李克特量表从 1（绝对错误）到 5（绝对正确）进行排序。首先发送初始调查，然后发送提醒卡给未回复者，并进行第二次调查。分析包括描述性统计、学生 t 检验、方差分析以及与新西兰心脏病专家的平均得分进行比较。
本研究的应答率为 46.9%（434/925）。应答者的中位年龄为 41-50 岁；他们大多是男性（72.6%），大多数有超过 10 年的临床经验（66.8%）。REI-40 的理性平均得分高于经验平均得分（3.93/5（SD 0.35）与 3.33/5（SD 0.49），p<0.0001），与新西兰心脏病专家的平均得分相似（理性平均 3.93/5，经验平均 3.05/5）。女性应答者的经验平均得分显著高于男性应答者（3.40/5（SD 0.49）与 3.30/5（SD 0.48），p=0.003）。
总体而言，急诊医师更倾向于理性决策，而不是经验决策；然而，女性急诊医师的经验得分高于男性急诊医师。这对未来在急诊医师中进行知识转化和决策支持工作具有重要意义。
