Can Med Educ J. 2012 Sep 30;3(2):e98-e106. eCollection 2012.
Consistency in diagnostic suggestions does not influence the tendency to accept them.
Canadian medical education journal
Kees van den Berge, Silvia Mamede, Tamara van Gog, Jan van Saase, Remy Rikers
Affiliations
Affiliations
- Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands.
- Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands ; Department of Psychology, Erasmus University Rotterdam, Rotterdam, the Netherlands.
- Department of Psychology, Erasmus University Rotterdam, Rotterdam, the Netherlands.
PMID: 26451191
PMCID: PMC4563636
Abstract
BACKGROUND: Studies suggest that residents tend to accept diagnostic suggestions, which could lead to diagnostic errors if the suggestion is incorrect. Those studies did not take into account that physicians in clinical practice will mainly encounter correct suggestions. The present study investigated residents' diagnostic performance if they would first encounter a number of correct suggestions followed by a number of incorrect suggestions, and vice versa. It was hypothesized that more incorrect suggestions would be accepted if participants had first evaluated a series of correct suggestions.
METHOD: Residents (n = 38) evaluated suggested diagnoses on eight written clinical cases. Half of the participants first evaluated four correct suggestions and then evaluated four incorrect suggestions (C/I condition). The other half started with the four incorrect suggestions followed by the correct suggestions (I/C condition).
RESULTS: Our findings show that the evaluation score in the C/I condition (M = 2.87, MSE = 0.14) equaled that in the I/C condition (M = 2.66, MSE = 0.14), F(1,36) = 1.09, p = 0.30, ns, meaning that consistency in preceding suggested diagnoses did not influence the tendency to accept subsequent diagnostic suggestions. There was, however, a significant interaction effect between case order and phase, F(1,36) = 11.82, p = 0.001, η p (2) = 0.25, demonstrating that the score on cases with correct suggestions was higher than the score on cases with incorrect suggestions.
CONCLUSION: These findings indicate that consistency in preceding correct or incorrect diagnostic suggestions did not influence the tendency to accept or reject subsequent suggestions. However, overall residents still showed a tendency to accept diagnostic suggestions, which may lead to diagnostic errors if the suggestion is incorrect.
References
- Am J Med. 2008 May;121(5 Suppl):S2-23 - PubMed
- Acad Med. 1990 Oct;65(10):611-21 - PubMed
- Teach Learn Med. 2012;24(2):149-54 - PubMed
- J Gen Intern Med. 2005 Apr;20(4):334-9 - PubMed
- Med J Aust. 1995 Nov 6;163(9):458-71 - PubMed
- Med Educ. 2004 Dec;38(12):1302-8 - PubMed
- Med Educ. 2010 Jan;44(1):94-100 - PubMed
- Ann Intern Med. 2005 Jan 18;142(2):115-20 - PubMed
- JAMA. 2003 Jun 4;289(21):2849-56 - PubMed
- N Engl J Med. 2010 Nov 25;363(22):2124-34 - PubMed
- Qual Saf Health Care. 2006 Jun;15(3):174-8 - PubMed
- Med Educ. 2007 Dec;41(12):1185-92 - PubMed
- Acad Med. 2001 Oct;76(10 Suppl):S18-20 - PubMed
- Arch Intern Med. 2005 Jul 11;165(13):1493-9 - PubMed
- BMJ. 2005 Apr 2;330(7494):781-3 - PubMed
- JAMA. 2010 Sep 15;304(11):1198-203 - PubMed
- Acad Med. 2002 Oct;77(10 Suppl):S67-9 - PubMed
- Med Care. 2000 Mar;38(3):261-71 - PubMed
- Arch Intern Med. 2007 Feb 12;167(3):302-8 - PubMed
- N Engl J Med. 1991 Feb 7;324(6):370-6 - PubMed
- Organ Behav Hum Decis Process. 2001 Jan;84(1):23-53 - PubMed
- Acad Med. 2003 Aug;78(8):775-80 - PubMed
- N Engl J Med. 1983 Apr 28;308(17):1000-5 - PubMed
- Adv Health Sci Educ Theory Pract. 1997;2(2):173-184 - PubMed
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