Abstract

Intuition is a part of diagnostic reasoning and decision making in medicine and so in general practice (GP). In this research, I aimed to discover in which ways GP supervisors have attention for the intuitive elements of diagnostic reasoning and decision making of general practitioners in training (GP trainees).

Theoretically, I accessed this research question from the perspective of the compartments structure: context, process and result. During my research, I proceeded in contiguous and overlapping phases. The performed analyses are based on observations of tutorial dialogues -between GP supervisors and GP trainees- and on interviews with experts. It appeared that the attention for the intuitive elements was mainly of implicit nature. The doubts and insecurities of the GP trainees about their decision making mostly led to this attention. In the analyses, there also emerged a ‘new’ element, the interpersonal intuition. Also the GP supervisors carried out an example role that seemed to function as an implicit guidance for the GP trainees (hidden curriculum).Themes that stood out are lack of contextual knowledge of the GP trainees, the ‘hospital’-thinking of the GP trainees, dealing with the referral behaviour of the GP trainees and not blindly trusting intuition (intuition as a pitfall/ the importance of verifying). The views of the GP supervisors were diverse, though strikingly enough they all considered intuition in general practice to be gut feelings. It is recommended that the observations of the tutorial dialogues will be repeated with a broader and more varied sample of participants. Furthermore, the effects of awareness of these intuitive elements should be researched and its possible effects on the contact with patients. Besides this aspect, I recommended that both GP supervisors and GP trainees will receive education in these intuitive elements. This education should be incorporated into the general medical curriculum. Finally, it is advisable to give intuition -and the role it plays in the medical (GP) profession- the proper recognition and attention it deserves, via channels such as the ‘NHG-standards’, the LHV and the ‘Toekomstvisie Huisartsenzorg 2022’.

Susanna van de Waerdt, GP-trainee, April 2016.