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Conclusions

1. There is a diverse range of beliefs about and approaches to understanding medical thinking in communities that encounter each other relatively rarely. The participants in the meeting felt that the different approaches had valuable contributions to make and that it is important to create more opportunities to meet and exchange ideas and experience.

2. Empirical research in psychology and cognitive science has generated a number of important insights into medical thinking. The formal techniques developed in medical informatics and computer science have produced some interesting models of medical thinking. These two approaches could be viewed as complementary and it would be interesting to explore the potential synergy.

3. The focus has largely been on the thoughts and actions of individual decision-makers and on individual decisions or errors. This, however, is only part of the story; we also have to understand medical thinking socially and organisationally and seek better empirical methods of study and formal theoretical concepts.

4. Understanding medical thinking, in the broad sense identified here, is of course a key requirement for improving medical effectiveness, reducing error and improving patient safety and other benefits.

Next steps

1. To build on the nascent network of people and community of practice by organizing further meetings. The next meeting should aim to be more international and wide-ranging in its coverage. One possibility we are considering is to make a proposal for a Novartis Foundation Symposium on the topic. This would provide funds for a prestigious meeting whose proceedings would be published in book form.

2. To seek support (from national or international sources) for interdisciplinary research projects that will pull through the potential synergies identified at the meeting into practical concepts and tools.

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