Effect of enhanced analytic reasoning on diagnostic accuracy: A randomized controlled study

Background: Diagnostic error can be caused by several types of cognitive bias, which may be reversed by enhancing analytic reasoning. Aims: To evaluate whether enhancing analytic reasoning can increase diagnostic accuracy in objective structured clinical examination (OSCE) in medical students. Metho...

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Bibliographic Details
Published in:Medical teacher 2013-01, Vol.35 (3), p.248-250
Main Authors: Myung, Sun Jung, Kang, Seok Hoon, Phyo, Sae Ra, Shin, Jwa Seop, Park, Wan Beom
Format: Article
Language:English
Subjects:
Academic achievement
Accuracy
Adult
Clinical Medicine - education
Cognition & reasoning
College students
Comparative analysis
Control Groups
Curriculum
Diagnosis
Diagnosis, Differential
Diagnostic Errors - prevention & control
Education, Medical, Undergraduate
Female
Humans
Male
Medical Students
Novices
Objective structured clinical examinations
Republic of Korea
Standardized patients
Students, Medical
Thinking
Young Adult
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Summary:Background: Diagnostic error can be caused by several types of cognitive bias, which may be reversed by enhancing analytic reasoning. Aims: To evaluate whether enhancing analytic reasoning can increase diagnostic accuracy in objective structured clinical examination (OSCE) in medical students. Methods: All fourth-year medical students, randomly assigned to the analytic reasoning or control groups, undertook the OSCE with four cases using standardized patients. The analytic reasoning group was requested to list differential diagnoses and findings compatible or not compatible with each diagnosis prior to providing a diagnosis, while the control group provided a diagnosis without these processes. Mean diagnostic accuracy scores (perfect score, 4.0) from four cases of OSCE were compared between the two groups. Results: One hundred forty-five students were randomly assigned to the analytic reasoning group (n = 65) or the control group (n = 80). The baseline characteristics, including grade point average and the scores from each patient encounter, were comparable between groups. Mean diagnostic accuracy scores were significantly higher in the analytic reasoning group than in the control group (3.40 ± 0.66 versus 3.05 ± 0.98; p = 0.011). Conclusion: Enhancement of analytic reasoning may improve diagnostic accuracy in novice doctors.
ISSN:0142-159X
1466-187X
DOI:10.3109/0142159X.2013.759643