Multimethod study of clinical judgment.

Expert and novice clinicians judged the likelihood of disease alternatives and gave thinking-aloud protocols as they evaluated simulated cases of congenital heart disease. Specific combinations of cues in the patient data were manipulated to create alternate versions of a single case so that the use of critical cues could be identified. Analyses of variance of subjects' disease judgments revealed differences between expert and novice clinicians in their use of critical cues and cue combinations. Analyses of the thinking-aloud protocols revealed that clinicians with different degrees of expertise employed different interpretations of patient data cues as well as qualitatively distinct "lines of reasoning" in reaching clinical judgments.