title: Thinking Styles and Regret in Physicians.
abstract: BACKGROUND
  Decision-making relies on both analytical and emotional thinking. Cognitive reasoning styles (e.g. maximizing and satisficing tendencies) heavily influence analytical processes, while affective processes are often dependent on regret. The relationship between regret and cognitive reasoning styles has not been well studied in physicians, and is the focus of this paper.
  
  
  METHODS
  A regret questionnaire and 6 scales measuring individual differences in cognitive styles (maximizing-satisficing tendencies; analytical vs. intuitive reasoning; need for cognition; intolerance toward ambiguity; objectivism; and cognitive reflection) were administered through a web-based survey to physicians of the University of South Florida. Bonferroni's adjustment was applied to the overall correlation analysis. The correlation analysis was also performed without Bonferroni's correction, given the strong theoretical rationale indicating the need for a separate hypothesis. We also conducted a multivariate regression analysis to identify the unique influence of predictors on regret.
  
  
  RESULTS
  165 trainees and 56 attending physicians (age range 25 to 69) participated in the survey. After bivariate analysis we found that maximizing tendency positively correlated with regret with respect to both decision difficulty (r=0.673; p<0.001) and alternate search strategy (r=0.239; p=0.002). When Bonferroni's correction was not applied, we also found a negative relationship between satisficing tendency and regret (r=-0.156; p=0.021). In trainees, but not faculty, regret negatively correlated with rational-analytical thinking (r=-0.422; p<0.001), need for cognition (r=-0.340; p<0.001), and objectivism (r=-0.309; p=0.003) and positively correlated with ambiguity intolerance (r=0.285; p=0.012). However, after conducting a multivariate regression analysis, we found that regret was positively associated with maximizing only with respect to decision difficulty (r=0.791; p<0.001), while it was negatively associated with satisficing (r=-0.257; p=0.020) and objectivism (r=-0.267; p=0.034). We found no statistically significant relationship between regret and overall accuracy on conditional inferential tasks.
  
  
  CONCLUSIONS
  Regret in physicians is strongly associated with their tendency to maximize; i.e. the tendency to consider more choices among abundant options leads to more regret. However, physicians who exhibit satisficing tendency - the inclination to accept a "good enough" solution - feel less regret. Our observation that objectivism is a negative predictor of regret indicates that the tendency to seek and use empirical data in decision-making leads to less regret. Therefore, promotion of evidence-based reasoning may lead to lower regret.
authors.affiliation: University of South Florida, Morsani College of Medicine, Tampa, Florida, United States of America.
authors.forename: Mia
authors.initials: M
authors.lastname: Djulbegovic
authors.affiliation: College of Nursing, University of South Florida, Tampa, Florida, United States of America.
authors.forename: Jason
authors.initials: J
authors.lastname: Beckstead
authors.affiliation: School of Applied Social Sciences, De Montfort University, Leicester, United Kingdom.
authors.forename: Shira
authors.initials: S
authors.lastname: Elqayam
authors.affiliation: University of South Florida, Morsani College of Medicine, Tampa, Florida, United States of America; Program for Comparative Effectiveness Research, University of South Florida, Tampa, Florida, United States of America.
authors.forename: Tea
authors.initials: T
authors.lastname: Reljic
authors.affiliation: University of South Florida, Morsani College of Medicine, Tampa, Florida, United States of America; Program for Comparative Effectiveness Research, University of South Florida, Tampa, Florida, United States of America; Division of Evidence-Based Medicine, Department of Medicine, University of South Florida, Tampa, Florida, United States of America.
authors.forename: Ambuj
authors.initials: A
authors.lastname: Kumar
authors.affiliation: University of South Florida, Morsani College of Medicine, Tampa, Florida, United States of America; Tampa General Hospital, Tampa, Florida, United States of America.
authors.forename: Charles
authors.initials: C
authors.lastname: Paidas
authors.affiliation: University of South Florida, Morsani College of Medicine, Tampa, Florida, United States of America; Program for Comparative Effectiveness Research, University of South Florida, Tampa, Florida, United States of America; Division of Evidence-Based Medicine, Department of Medicine, University of South Florida, Tampa, Florida, United States of America; Department of Hematology and Health Outcomes Research, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, United States of America; Tampa General Hospital, Tampa, Florida, United States of America.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Djulbegovic
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002755:Choice Behavior; D003657:Decision Making; D004644:Emotions; D019348:Empiricism; D019317:Evidence-Based Medicine; D005431:Florida; D006801:Humans; D008875:Middle Aged; D008960:Models, Psychological; D010549:Personal Satisfaction; D010820:Physicians / Q000523:psychology*; D013850:Thinking