Clinical Decision-making among Emergency Physicians: Experiential or Rational?

It has been postulated that everyone has an affinity for one of two cognitive approaches: experiential (intuitive) or rational (conscious). The aim of this study was to analyze the thinking processes of Saudi emergency physicians at nine hospitals in Riyadh. This was a cross-sectional study, which was undertaken in Riyadh using a psychometric tool called the Rational–Experiential Inventory-40. The survey, sent by e-mail to 202 emergency physicians, had a 53% response rate. Most respondents were male (86%). The total surveyed participants included consultants (36%), associate consultants (19%), registrars, fellow or staff physicians (7%), and residents (38%). The results found a mean (standard deviation) score of 3.73 (0.51) for rational approaches to decision-making and 3.09 (0.45) for experiential approaches among the emergency physicians surveyed. The difference of 0.46 between the two scores was not statistically significant (p = 0.23). Female emergency physicians tended toward slower logical thinking (rational). Consultant emergency physicians had a higher score for fast intuitive automatic thinking (experiential) than nonconsultant physicians. This was statistically significant, t(105) = 2.1, p = 0.4. Our results suggest that although both thinking styles are used in clinical decision-making, consultant emergency physicians prefer rational approaches to decision-making.