Emerging paradigms of cognition in medical decision-making

Vimla L. Patel, David R. Kaufman, Jose F. Arocha

Research output: Contribution to journalArticlepeer-review

220 Scopus citations


The limitations of the classical or traditional paradigm of decision research are increasingly apparent, even though there has been a substantial body of empirical research on medical decision-making over the past 40 years. As decision-support technology continues to proliferate in medical settings, it is imperative that "basic science" decision research develop a broader-based and more valid foundation for the study of medical decision-making as it occurs in the natural setting. This paper critically reviews both traditional and recent approaches to medical decision making, considering the integration of problem-solving and decision-making research paradigms, the role of conceptual knowledge in decision-making, and the emerging paradigm of naturalistic decision-making. We also provide an examination of technology-mediated decision-making. Expanding the scope of decision research will better enable us to understand optimal decision processes, suitable coping mechanisms under suboptimal conditions, the development of expertise in decision-making, and ways in which decision-support technology can successfully mediate decision processes.

Original languageEnglish (US)
Pages (from-to)52-75
Number of pages24
JournalJournal of Biomedical Informatics
Issue number1
StatePublished - 2002
Externally publishedYes


  • Biases
  • Cognition
  • Conceptual knowledge
  • Diagnostic reasoning
  • Distributed cognition
  • Heuristics
  • Medical decision-making
  • Naturalistic problem solving
  • Research paradigms

ASJC Scopus subject areas

  • Computer Science Applications
  • Health Informatics


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