Smart doctors and the three metaphors of learning

摘要

The article by Odette Wegwarth and her colleagues describes conceptual tools to promote decision making in medical practice.1 They propose that there are two main ways of approaching decision making and clinical reasoning. The first, optimisation, involves attempts to integrate all available information in order to arrive at sound decisions. The second solution strategy is to apply heuristics, that is, rules of thumb that are based on less complete information. At the root of their argument lies the belief that adding increasing amounts of information can detract from the accuracy of the decisions made. This contention is so strongly counter to the intuitions of many that it is worth revisiting and reinforcing some of the reasons why this might be so, while also considering Wegwarth et a's argument in the context of other models of learning.