Pre-Clerkship Medical Students’ Experiences and Perspectives of System 1 and System 2 Thinking: A Qualitative Study

Dual-process theories may be invoked to explain how physicians interact with, interpret, and draw inferences from clinical information. Stanovich West’s model articulates two kinds of thinking—intuitive-based System 1 analytical-based 2—which have been under-investigated with in training. This qualitative study explored pre-clerkship medical students’ retrospective perspectives experiences 2 thinking via 12 semi-structured interviews abductive, progressive focusing. Participants identified patient interactions, note writing, knowledge synthesis, problem list differential diagnosis generation, evaluating evidence, critical appraisal literature as opportunities engage or thinking. Six major themes emerged analysis participants’ interview transcripts: cognitive processes, deliberate practice, learning environment: being alone together, stickiness factor, biases heuristics, prior experience attaining competence. valued the anticipated role that will play their future experienced nascent, self-regulated development these processes during phase education without formal feedback coaching clinician preceptors. Pre-clerkship curricula should further embrace low-stakes, incremental teaching on metacognition continuous monitoring processing a key competency for physician learners.