Unlocking intuition and expertise: using interpretative phenomenological analysis to explore clinical decision making

Abstract

Background: Clinical decision making is a complex, but important, research area. Decision-making theories have evolved to recognise that, although heuristics and biases can lead to error, expert clinician decision makers can also use intuition to good effect. More research is needed to understand how nurses and other clinicians make sense of complexity and uncertainty. Aim: This paper discusses the utility of interpretative phenomenological analysis to elucidate clinical decision making, expertise and intuition. Methods: A narrative review of published interpretative phenomenological analysis studies exploring clinical decision-making, and discussion of an exemplar study. Results: A limited number of interpretative phenomenological analysis studies have been published in this area. By seeking out descriptions of real-world decision making, interpretative phenomenological analysis research provides ecologically valid insights into what it is like to make time-critical, high-stakes decisions with limited information. Conclusion: Contributing to the study of complex clinical decision making in combination with other research approaches, interpretative phenomenological analysis research has significant unrealised potential to inform education, assessment and support interventions and the development of clinical guidelines. Future applications could enhance understanding of multi-disciplinary decision-making and the development of expertise and intuition, over time.