Adding guidance to deliberate reflection improves medical student’s diagnostic accuracy

• Published in: Medical education 2021-10, Vol.55 (10), p.1161-1171
• Main Authors: Fernandes, Rachel Aparecida Ferreira, Malloy‐Diniz, Leandro Fernandes, Vasconcellos, Marcos Carvalho, Camargos, Paulo Augusto Moreira, Ibiapina, Cássio
• Format: Article
• Language: English
• Subjects: Accuracy; Critical thinking; Medical diagnosis; Medical education; Medical students; Reflective practice
• ISSN: 0308-0110; 1365-2923
• DOI: 10.1111/medu.14563

Context Diagnostic competence in students is a major medical education goal. Adding instructional guidelines to prompt deliberate reflection fosters medical students’ diagnostic proficiency. This study investigates the effects of this teaching strategy on diagnostic accuracy in solving clinical cases of different complexity levels by novice and senior students. Method Eighty third‐year and 62 sixth‐year medical students participated in this three‐phase experimental study. First, participants were randomly assigned to one of three experimental conditions (free reflection, cued reflection and worked example) to diagnose 12 clinical text‐based cases, following different levels of deliberate reflection. In an immediate test and a delayed test, the participants diagnosed varied sets of 12 cases, six involving the same diseases (four routine and two rare). The main outcomes were the diagnostic accuracy scores achieved for the cases assessed by repeated measures of analysis of variance for each category. Results There was a significant primary effect of experimental condition (P