AI Rounds by the Cumming School of Medicine
Jun 3, 2026 · 36 min · 11 segments
For decades, we've understood human reasoning through two systems: the fast, intuitive one and the slow, deliberate one. But that framework was built before AI became a thinking partner. In this…
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Now, most of us have probably heard of Kahneman's thinking fast and slow.
And even if you haven't read it in full, you've probably encountered the core idea at some point in your training.
Kahneman describes two modes of thinking that the human mind uses to process information and to make decisions.
It operates below our conscious awareness, drawing on pattern recognition, prior experience, and intuition.
When you walk into a room and you immediately sense something is off, or when you recognize a familiar face in the crowd, that's System 1 at work.
In clinical context, it might be as a physician when you walk into a patient's room and you just have that gut feeling, this isn't going well.
It's recruited when a problem requires careful analysis, when something conflicts with our expectations, or when the stakes are high enough to warrant some scrutiny.
Working through a differential diagnosis step-by-step, evaluating the methodology of a paper before accepting its conclusions, or constructing a rubric for assessing student work.
It's more reliable in complex and unfamiliar situations, but it's resource-intensive, so we don't sustain System 2 thinking all the time.
The tension between these two systems actually explains a lot of human behavior.
System 2 gets recruited when conflict or uncertainty is detected, but only if we're not tired, rushed, or cognitively overloaded.
That two-system framework has been foundational in cognitive psychology and decision science for decades.
Now, most of us have probably heard of Kahneman's thinking fast and slow.
And even if you haven't read it in full, you've probably encountered the core idea at some point in your training.
Kahneman describes two modes of thinking that the human mind uses to process information and to make decisions.
It operates below our conscious awareness, drawing on pattern recognition, prior experience, and intuition.
When you walk into a room and you immediately sense something is off, or when you recognize a familiar face in the crowd, that's System 1 at work.
In clinical context, it might be as a physician when you walk into a patient's room and you just have that gut feeling, this isn't going well.
It's recruited when a problem requires careful analysis, when something conflicts with our expectations, or when the stakes are high enough to warrant some scrutiny.
Working through a differential diagnosis step-by-step, evaluating the methodology of a paper before accepting its conclusions, or constructing a rubric for assessing student work.
It's more reliable in complex and unfamiliar situations, but it's resource-intensive, so we don't sustain System 2 thinking all the time.
The tension between these two systems actually explains a lot of human behavior.
System 2 gets recruited when conflict or uncertainty is detected, but only if we're not tired, rushed, or cognitively overloaded.
That two-system framework has been foundational in cognitive psychology and decision science for decades.
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