Intuition and evidence - Uneasy bedfellows?

Abstract

Intuition is a decision-making method that is used unconsciously by experienced practitioners but is inaccessible to the novice. It is rapid, subtle, contextual, and does not follow simple, cause-and-effect logic. Evidence-based medicine offers exciting opportunities for improving patient outcomes, but the 'evidence-burdened' approach of the inexperienced, protocol-driven clinician is well documented. Intuition is not unscientific. It is a highly creative process, fundamental to hypothesis generation in science. The experienced practitioner should generate and follow clinical hunches as well as (not instead of) applying the deductive principles of evidence-based medicine. The educational research literature suggests that we can improve our intuitive powers through systematic critical reflection about intuitive judgements - for example, through creative writing and dialogue with professional colleagues. It is time to revive and celebrate clinical storytelling as a method for professional education and development. The stage is surely set for a new, improved - and, indeed, evidence-based - 'Balint' group.