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 illn ess scripts are tested. Participants at 4 levels of medical expertise were asked to describe either a prototypical patient or the clinical picture ass ociated with a number of different diseases. It was found that participants at intermediate levels of expertise mentioned, both absolutely and relativ ely, many enabling conditions (patient contextual factors such as sex, age, medical history, and occupation) when asked to describe a prototypical pat ient with a disease, whereas the instruction to describe the clinical pictu re of a disease revealed a monotonic relation with expertise level. The amo unt of biomedical information in the descriptions decreased with increasing expertise level for both types of instruction. In addition, a positive rel ation was found between number of actual patients seen with a particular di sease and number of enabling conditions mentioned. These results were inter preted as supportive of the present conceptualization of the illness script theory.