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Table 1 Study overview and the four steps of assessing a Decision Process Matrix

From: Tracing the decision-making process of physicians with a Decision Process Matrix

Step Activities Assessing Method Who Timepoint
1 Observing and recording relevant medical information Cues Taking notes Student Throughout the entire diagnostic process
2 Assessing options in terms of suspected diagnoses Options Open question Student & resident Immediately after the initial contact with patient (after MHT/PE)
3 Drawing up an initial version of the DPM Raw version of DPM Transferring cues and options Student Between MHT/PE and waiting for I&LT
4 Verifying and completing the DPM and finally adding of confidence ratings Final versions incl. numbering and confidence ratings Thinking aloud, reference scale Resident & student Directly after the discharge of the patient
  1. The naturalistic decision-making process of 11 residents and a total of 55 medical cases were recorded in a emergency department. For each medical case a Decision Process Matrix [DPM] was drawn up according to a semi-structured technique following steps 1–4. For each step the activities, assessed parts of the DPM, method used, person(s) involved, and timepoint during the diagnostic process are indicated. Resident and student both had to agree in the final DPM. Further abbreviations: MHT, medical history-taking; PE, physical examination; I&LT, imaging and laboratory tests