Diagnostic Styles of Attending Pediatricians, Residents, and Nurses in Evaluating Febrile Children

In order to compare the diagnostic styles of attending pediatricians (A), residents (R), and nurses (N) in judging the degree of illness of a febrile child prior to physical examination, we studied the frequency with which they used 139 different history variables and 186 observation variables in evaluating 162 consecutive children ≤24 months of age with temperature ≥38.3 C. Because individual history and observation variables were not used with sufficient frequency, comparison of diagnostic styles based on the individual variables was not possible. The individual history and observation variables were then combined into 25 history and 30 observation categories respectively. One observation category, "Eyes," was used with sufficient frequency to allow com parison of A, R, and N diagnostic styles. In the Eyes category, there were 11 variables describing visual response to stimuli (e.g., looking at the observer) and 10 variables describing appearance of the eyes (e.g., glassy, shiny). Attendings used variab...