Proceedings of the Annual Meeting of the Cognitive Science Society

This study examined the problem solving strategies used by staff radiologists and radiology residents during the interpretation of difficult mammograms. Ten radiologists and ten residents diagnosed 10 cases under two experimental conditions (authentic and augmented). In the authentic condition, standard unmarked mammograms were used. Mammographic findings were highlighted on a second set of the same cases for the augmented condition. Verbal protocols were analyzed and revealed that mammography interpretation was characterized by a predominant use of data-driven or mixed-strategies depending on case typicality and clinical experience. Repeated measures ANOVAs revealed that the radiologists scanned the cases significantly faster than the residents. No group differences were found in the number of radiological findings, radiological observations, and number of diagnoses across experimental conditions. Frequency analyses revealed that regardless of experimental condition both groups (a) used the same types of operators, control processes, diagnostic plans, (b) committed the same number of errors, and (c) committed case-dependent errors. Overall, the fact that few differences were found between the groups on the various measures may be due to the fact that mammogram interpretation is a well-constrained visual cognitive task. The results have been applied to the design of a computer-based tutor for training residents to interpret mammograms. Future empirical directions include building a more comprehensive model of the perceptual and cognitive processes underlying mammogram interpretation by converging eye-movement, cortical activation (e.g., fMRI) and verbal protocol data.