The predictive validity of the decision styles scale: An evaluation across task types

Influence of risk literacy, decision-making styles and motivation on clinical reasoning in medical students: an ordinal logistic regression analysis

BACKGROUND

Clinical reasoning is critical to the medical profession and should be a central component of the medical curriculum. However, there are different explanations of how clinical reasoning works, and there is little research on how it develops during medical education. The aim of this study is to investigate factors, i.e. skills, processes and motivations, which influence clinical reasoning in medical students.

METHODS

128 data sets were included in our study. We focused on the diagnostic aspect and therefore used students' Bayesian reasoning ability in three medical case scenarios (0-3 points) as the outcome parameter. The study measures students' risk literacy (Berlin Numeracy Test, 0-4 points) as a skill, their decision-making style as an intuitive and/or rational process (Decision Styles Scale, each 1-5 points) and identifies the role of motivation (questionnaire with 5-point Likert scales) in relation to academic goals as a potential influence on clinical reasoning. We used an ordinal logistic regression model for analysis.

RESULTS

Ordinal logistic regression showed that risk literacy is more important for solving medical case scenarios than students' motivation to become researchers. The chance of solving ≥ 1 scenario increased by 33% when the highest BNT score was compared to the lowest, compared to a 27% increase for the highest motivation to become a researcher. The probability of obtaining ≥ 1 point in the scenarios rose 20% when the BNT score went from three to four, indicating that highly risk-literate students have a higher ability to solve Bayesian tasks. Yet, the ability to perform Bayesian reasoning also increased consistently with growing motivation to become a researcher.

CONCLUSIONS

The study highlights the importance of paying attention to medical students' risk literacy in the development of clinical reasoning, as it appears to be a critical component. Motivation also plays an important role and, accordingly, should be encouraged in medical education.

Choice experiment selection of tourism destinations in a dual process theory framework: The role of decision style and potential to promote deliberation

Models of consumer choice that assume rational decision processes are too simplistic, as they ignore intuitive processes and combinations of intuition and rationality. In dual process theory, System 1 processes are intuitive, fast, require low cognitive effort, and involve autonomous systems, while System 2 processes are deliberative, slower, reflect greater cognitive effort, and involve controlled attention. The dual process framework facilitates understanding of decision processes that may be diverse and complex. Based on response time as an indicator of System 2 use, we fill gaps in the tourism and choice experiment literatures by i) assessing the dimensionality of a decision style scale and its role in predicting System 2 use and ii) assessing whether researcher interventions, such as instructions, can promote System 2 use. The study is based on survey-based choice experiment responses of 483 domestic and international visitors across two Norwegian nature-based tourism destination contexts. Each visitor completed four choice experiment tasks for a total of 1,932 choice occasions. Results indicated diversity in extent of System 2 use. The decision style scale was multidimensional with both the intuitive and rational subscales predicting response time. We encourage inclusion of decision style scales–and specifically multidimensional scales–in future tourism choice and choice experiment applications. Statistically significant coefficients for instructions and unhurriedness suggest potential for researchers to increase System 2 processing in survey tasks. We encourage future use of this intervention, especially when survey tasks are intended to replicate “real world” decisions that rely heavily on System 2 use.