PERVASIVENESS OF FRAMING EFFECTS AMONG PHYSICIANS AND MEDICAL-STUDENTS

Researchers have been documenting the influence of framing upon decision making for more than two decades; decisions appear to change in response to superficial changes in the presentation of possible outcomes. Several studies of medical decision making have revealed, for instance, that clinical decisions differ when options are presented as gains (survival rates) rather than losses (mortality rates). However, most studies of framing effects in the medical domain have utilized a very limited number of clinical problems that have not allowed an adequate test of the prevalence of the phenomena. To extend previous studies, we presented three groups of subjects (experienced internists, residents, and third-year medical students) with booklets containing twelve hypothetical medical cases. Half of the subjects received gain versions and half received loss versions of the same cases. Chi-square analyses revealed that framing did not influence any of the decisions of medical students and influenced the decisions of residents and experienced physicians on only two of the clinical problems (the same two problems). It appears that the prevalence of framing effects in the clinical domain may be limited.