The role of illness scripts in the development of medical diagnostic expertise: Results from an interview study

In this article, we describe a study in which some current ideas about illness scripts are tested. Participants at 4 levels of medical expertise were asked to describe either a prototypical patient or the clinical picture associated with a number of different diseases. It was found that participants at intermediate levels of expertise mentioned, both absolutely and relatively, many enabling conditions (patient contextual factors such as sex, age, medical history, and occupation) when asked to describe a prototypical patient with a disease, whereas the instruction to describe the clinical picture of a disease revealed a monotonic relation with expertise level. The amount of biomedical information in the descriptions decreased with increasing expertise level for both types of instruction. In addition, a positive relation was found between number of actual patients seen with a particular disease and number of enabling conditions mentioned. These results were interpreted as supportive of the present conceptualization of the illness script theory.