Professional Competence and Intuitive Decision Making: A Simulation Study in the Domain of Emergency Medicine

Intuition presents as a crucial component of professional competence for many occupations, including emergency physicians because many of their decisions have to be made quickly. When arriving at the scene of an accident, they promptly have to assess the circumstances and initiate immediate life-saving measures without opportunities for deep analyses of patients' conditions. Therefore, spontaneous and intuitive decisions are required to solve the problem appropriately, rather than more intentional and time-consuming forms of decision-making. Yet, the efficacy of and processes underpinning these intuitive activities remain far from fully understood or clearly conceptualised. The study reported here aims at revealing the efficacy of such intuition by analysing decision-making behaviour of emergency physicians. Based on patient simulation mannequins, which can be programmed to present specified clinical situations, three groups of participants with different levels of emergency medicine expertise (n (1) = 10 novices, n (2) = 10 semi-experts, n (3) = 10 experts) each addressed two different authentic problem cases. In the first simulation, time pressure was utilised to press participants to decide intuitively. In the second simulation, the participants had to legitimise their decisions without any time pressure in order to generate rational decisions. Whereas no clear difference in the participants' performances between both cases could be identified, experts and semi-experts performed better than novices in their intuitive decision-making, thereby supporting beliefs about the efficacy of intuition. It is proposed that medical education, as well as other forms of occupational preparation, should consider theories of mental simulations in order to improve surgeons' professional education.