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


Nicola McCleary;




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.