A PROTOCOL-BASED CODING SCHEME FOR THE ANALYSIS OF MEDICAL REASONING

One of the most common methods of codifying and interpreting human knowledge is through the use of verbal protocol analysis. Although the application of this methodology has increased in recent years, few detailed examples are readily available in the literature. This paper discusses the theoretical issues and methodological procedures pertaining to the analysis of verbal protocols collected from physicians engaged in medical problem solving. We first present a brief historical perspective on verbal protocol methodology. We then discuss how we have come to view the task of medical diagnosis both in general and in particular with respect to a specific specialty-congenital heart disease. Next, we describe and provide examples of our methodology for coding verbal protocols of physicians into abstract, but meaningful objects which are elements of a theory of diagnostic reasoning. In particular, we demonstrate how the coding scheme can represent an important aspect of medical problem solving behavior called a line of reasoning. We conclude by proposing how such analysis is important to understanding the psychology of medical problem solving and how this type of analysis plays an important role in the development of medical artificial intelligence systems and educational efforts directed toward the development of expertise in medical problem solving. © 1992.