Can Medical Diagnosis Benefit from “Unconscious Thought”?

© Society for Medical Decision Making.The unconscious thought theory argues that making complex decisions after a period of distraction can lead to better decision quality than deciding either immediately or after conscious deliberation. Two studies have tested this unconscious thought effect (UTE) in clinical diagnosis with conflicting results. The studies used different methodologies and had methodological weaknesses. We attempted to replicate the UTE in medical diagnosis by providing favorable conditions for the effect while maintaining ecological validity. Family physicians (N = 116) diagnosed 3 complex cases in 1 of 3 thinking modes: immediate, unconscious (UT), and conscious (CT). Cases were divided into short sentences, which were presented briefly and sequentially on computer. After each case presentation, the immediate response group gave a diagnosis, the UT group performed a 2-back distraction task for 3 min before giving a diagnosis, and the CT group could take as long as necessary before giving a diagnosis. We found no differences in diagnostic accuracy between groups (P = 0.95). The CT group took a median of 7 s to diagnose, which suggests that physicians were able to diagnose online, as information was being presented. The lack of a difference between the immediate and UT groups suggests that the distraction had no additional effect on performance. To assess the decisiveness of the evidence of this null result, we computed a Bayes factor (BF01) for the 2 comparisons of interest. We found a BF01 of 5.76 for the UT versus immediate comparison and of 3.61 for the UT versus CT comparison. Both BFs provide substantial evidence in favor of the null hypothesis: physicians diagnoses made after distraction are no better than diagnoses made either immediately or after self-paced deliberation

Who earns more and why? A multiple mediation model from personality to salary

Purpose The purpose of this study was to investigate multiple indirect Big Five personality influences on professionals’ annual salary while considering relevant mediators. These are the motivational variables of occupational self-efficacy and career-advancement goals, and the work status variable of contractual work hours. The motivational and work status variables were conceptualized as serial mediators (Big Five → occupational self-efficacy/career-advancement goals → contractual work hours → annual salary). Design/Methodology/Approach We realized a 4 year longitudinal survey study with 432 participants and three points of measurement. We assessed personality prior to the mediators and the mediators prior to annual salary. Findings Results showed that except for openness the other Big Five personality traits exerted indirect influences on annual salary. Career-advancement goals mediated influences of conscientiousness (+), extraversion (+), and agreeableness (−). Occupational self-efficacy mediated influences of neuroticism (–) and conscientiousness (+). Because the influence of occupational self-efficacy on annual salary was fully mediated by contractual work hours, indirect personality influences via occupational self-efficacy always included contractual work hours in a serial mediation. Implications These findings underline the importance of distal personality traits for career success. They give further insights into direct and indirect relationships between personality, goal content, self-efficacy beliefs, and an individual’s career progress. Originality/Value Previous research predominantly investigated direct Big Five influences on salary, and it analyzed cross-sectional data. This study is one of the first to investigate multiple indirect Big Five influences on salary in a longitudinal design. The findings support process-oriented theories of personality influences on career outcomes