Intuition, analysis and reflection: An experimental study into the decision-making processes and thinking dispositions of osteopathy students

Background: Decision-making and reflective thinking are fundamental aspects of clinical reasoning. How osteopathy students think and make decisions will therefore have far-reaching implications throughout their professional lives. Models of decision-making are firmly established in cognitive science literature and their application is universal, yet the decision-making processes and thinking dispositions of osteopathy students remain relatively unexplored. Objectives and method: Using the Cognitive Reflection Test (CRT) to measure decision-making preferences and the 41-item Actively Open-minded Thinking disposition scale (AOT), this study set out to explore how osteopathy students at the start (novice; n = 44) and end (intermediate; n = 32) of their pre-professional training make decisions and how reflectively they think. Results: Intermediate level practitioners demonstrate significantly more analytical decision-making than their novice peers (p = 0.007; effect size = 0.31); however, reflective thinking dispositions do not change as participants progress through their training (p = 0.07). No significant association was found between analytical decision-making and reflective thinking (p = 0.85). Conclusions: The trend for intermediate level practitioners to demonstrate more analytical decision-making than novices, without significant differences in reflective thinking processes, supports other research that suggests osteopathic education promotes deductive over inductive reasoning in its graduates and that reasoning and thinking dispositions may develop independently of each other, given the skills and knowledge-based requirements of osteopathic education. (C) 2014 Elsevier Ltd. All rights reserved.