Table 1

Step-by-Step Procedure for Using the Critical Decision Method

Step 1The participant defines the scope of the event, ie, whether it took place during a single consultation or over multiple consultations. The scope is refined, if necessary, by the interviewer to cover only the participant’s involvement. For example, details of patients’ secondary care and outcome or related consultations with other family physicians were noted but not probed
Step 2The interviewer repeats back the account to be updated or corrected until a shared understanding of the episode is reached
Step 3A timeline of events is drawn on paper to aid accurate elicitation of decision information, paying attention to when new information was received and when key decisions were made
Step 4Using the timeline, the interviewer probes the account for more detail at points of new information, judgments, decisions, and reasoning processes. In this way, the implicit information and processes that were active during the episode are elicited
Step 5Hypothetical questions are asked to identify the implicit cues critical to intuitive decisions, for example, “What if the blood results were normal? How would that change your appraisal?”