Clinical judgement and clinical training.

The literature indicates that clinical judgement may sometimes be adversely affected by clinical training. It is suggested that this reflects qualitative changes in the modes of clinical listening, modes of inference, and relative weights given to stereotypic and individual information. A theoretical discussion of this issue focuses mainly on the hypothesis that training leads to relatively high-risk strategies of judgement, and on the construct validity of analytic and non-analytic judgement. It is suggested that clinical training needs to give separate attention to the use of objective 'low-risk' and of more intuitive styles of clinical judgement, and to consider the judicious combination of these. Practical approaches to both kinds of training are discussed.