Nurse Practitioners’ Versus Physicians’ Diagnostic Reasoning Style and Use of Maxims: A Comparative Study

• Nurse practitioners (NPs) use more nonanalytic reasoning than resident doctors.
• NPs and resident doctors trigger analytic reasoning when analyzing a complex case.
• Both groups identify with certain principals to aid in diagnostic reasoning.

The study used an intuitive/analytic reasoning instrument and maxims questionnaire to compare 1) the diagnostic reasoning style of 30 nurse practitioners (NPs) and 16 resident doctors and 2) its influence on their diagnostic reasoning abilities of a complex case. The results showed NPs incorporated more system I (intuitive) processes when compared with residents; however, both groups identified with certain maxims. Diagnostic reasoning style was not related to participants' diagnostic reasoning abilities, indicating they triggered system II (analytic) processes when required. Although system I processes are essential, clinicians need to be aware of the value and pitfalls associated with them.