PhD Project

Whether or not primary care patients receive evidence-based, high quality care depends in large part on the clinical decisions made by General Practitioners (GPs). This study is using patient scenarios (clinical/case vignettes), which describe patients presenting to primary care, to explore the cognitive processes underlying GPs’ decision-making.

Scenarios are being used to investigate the relationships among certain consultation/GP characteristics and three components of decision-making: how difficult GPs perceive decisions to be, the time taken to make decisions, and the quality of the decisions relative to clinical guideline recommendations. This study will also involve a review of patient scenario methodology in studies of GPs’ decision-making.

This study has four overall aims:

  • To conduct a systematic review to a) determine the extent to which perceived decision difficulty, decision quality, and their relationship have been assessed in scenario studies of GPs’ decision-making; b) identify possible determinants of difficulty and quality, and c) investigate the relationship between difficulty and quality
  • To determine the relationships between decision difficulty, decision quality and consultation/GP characteristics in existing datasets
  • To determine the relationship between decision time, decision difficulty, decision quality and consultation/GP characteristics in patient scenarios delivered using a web-based system
  • To identify factors associated with high quality, evidence-based clinical decisions, and make recommendations for an intervention to support GPs in making these decisions





McCleary N, Francis J, Ramsay C, Campbell MK, Allan J. Using patient scenarios to assess General Practitioners' decision difficulty and quality: A systematic review [abstract]. Psychol Health 2013;28 (Suppl.1):125.