Introduction: Cognitive processing theories postulate that decision making depends on both fast and slow thinking. Experienced physicians (EPs) make diagnoses quickly and with less effort by using fast, intuitive thinking, whereas inexperienced medical students rely on slow, analytical thinking. This study used a cognitive task analysis to examine EPs cognitive processes and ability to provide knowledge translation to learners. Methods: A novel mind mapping approach was used to examine how EPs translate their clinical reasoning to learners, when evaluating a patient for a possible venous thromboembolism (VTE). Nine EPs were interviewed and shown two different videos of a medical student patient interview (randomized from six possible videos). Results: EPs were asked to demonstrate their clinical approach to the scenario using a mind map, assuming they were teaching a learner in the Emergency Department. EPs were later re-interviewed to examine response stability, and given the opportunity to make clarifying or substantive mind map modifications. Maps were broken into component pieces and analyzed using mixed-methods techniques. A mean of 15.7 component pieces were identified within each mind map (standard deviation (SD) 7.8). Maps were qualitatively coded, with a mean of 2.8 clarifying amendments (e.g. adding a time course caveat) (SD 1.5-5.75) and 4.4 substantive modifications (e.g. changing the flow of the map) (SD 2-5). Conclusion: Resulting mind maps displayed significant heterogeneity in teaching points and the degree to which EPs used slow thinking. EPs frequently made fast thinking jumps, although learners could prompt slow thinking by questioning unclear points. This is particularly important as learners engage in cognitive apprenticeship throughout their training. An improved understanding of EPs cognitive processes through mind mapping will allow learners to improve their own clinical reasoning (Merrit et al., 2017). Educating EPs on these processes will allow modification of their teaching styles to better suit learners.
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