Information Representation for Judgment and Decision-Making in the Development of Expertise in Radiology: A Fuzzy-Trace Theory Analysis

Traditional information-processing accounts of the reasoning process in radiology assume that humans process the details of the input image in order to compute judgments. In these accounts, the development of expertise involves the acquisition of increasingly precise and complex internal problem representations that are based on a normal anatomy prototype. Fuzzy-trace theory predicts that accurate judgments rely on the reasoners ability to ignore irrelevant detail, to retrieve relevant gist memories and to accurately instantiate the image information with respect to the internal representation. Fuzzy-trace theory predicts that the development of expertise involves the ability to access and process less precise and complex internal representations (i.e., gist). The purpose of this study was to examine the internal representations used to make judgments in radiology and to quantify the changes in complexity of the internal representations, as well as the differences in time, accuracy and confidence that might be associated with experience. Thirty-five subjects from general and specialized expertise samples participated. Each subject was presented with 32 chest films including normal films, films with precise disease patterns (mass category) and diffuse disease patterns (interstitial and airspace category) . For each film, the participant made a series of judgments (normal/abnormal; category; specific diagnosis) and then sketched the features that were essential to the judgments