Representation scaffolds improve diagnostic efficiency in medical students

Medical Education

Volumn 51, Issue 11, 2017, Pages 1118-1126

  Braun, Leah T ^a   Zottmann, Jan M ^a   Adolf, Christian ^a   Lottspeich, Christian ^a   Then, Cornelia ^a   Wirth, Stefan ^b   Fischer, Martin R ^a   Schmidmaier, Ralf ^a  

^a LUDWIG MAXIMILIANS UNIVERSITY   (Germany)

^b UNIVERSITY OF MUNICH   (Germany)

Author keywords

[No Author keywords available]

Indexed keywords

CLINICAL COMPETENCE; CONTROLLED STUDY; FEMALE; HUMAN; MALE; MEDICAL EDUCATION; MEDICAL STUDENT; PROBLEM BASED LEARNING; RANDOMIZED CONTROLLED TRIAL; YOUNG ADULT;

CLINICAL COMPETENCE; EDUCATION, MEDICAL, UNDERGRADUATE; FEMALE; HUMANS; MALE; PROBLEM-BASED LEARNING; STUDENTS, MEDICAL; YOUNG ADULT;

EID: 85030989146     PISSN: 03080110     EISSN: 13652923     Source Type: Journal    
DOI: 10.1111/medu.13355     Document Type: Article

References (30)

1. Schmidt HG, Rikers RMJP. How expertise develops in medicine: knowledge encapsulation and illness script formation. Med Educ 2007;41 (12):1133–9.
2. Charlin B, Tardif J, Boshuizen HP. Scripts and medical diagnostic knowledge: theory and applications for clinical reasoning instruction and research. Acad Med 2000;75:182–90.
3. Schiff GD, Kim S, Abrams R, Cosby K, Lambert B, Elstein AS, McNutt RA. Diagnosing diagnosis errors: lessons from a multi-institutional collaborative project. In: Henriksen K, Battles JB, Marks ES, Lewin DI, eds. Advances in Patient Safety: From Research to Implementation (Volume 2: Concepts and Methodology). Rockville, MD: Agency for Healthcare Research and Quality (US) 2005.
4. Graber ML, Franklin N, Gordon R. Diagnostic error in internal medicine. Arch Intern Med 2005;165:1493–9.
5. Kiesewetter J, Ebersbach R, Gorlitz A, Holzer M, Fischer MR, Schmidmaier R. Cognitive problem solving patterns of medical students correlate with success in diagnostic case solutions. PLoS One 2013;8:e71486.
6. Custers EJ. Thirty years of illness scripts: theoretical origins and practical applications. Med Teach 2015;37:457–62.
7. Charlin B, Boshuizen HPA, Custers EJ, Feltovich PJ. Scripts and clinical reasoning. Med Educ 2007;41 (12):1178–84.
8. VanLehn K. Cognitive skill acquisition. Annu Rev Psychol 1996;47:513–39.
9. Charlin B, Lubarsky S, Millette B, Crevier F, Audétat M-C, Charbonneau A, Caire Fon N, Hoff L, Bourdy C. Clinical reasoning processes: unravelling complexity through graphical representation. Med Educ 2012;46 (5):454–63.
10. Kiesewetter J, Ebersbach R, Tsalas N, Holzer M, Schmidmaier R, Fischer MR. Knowledge is not enough to solve the problems – the role of diagnostic knowledge in clinical reasoning activities. BMC Med Educ 2016;16:303.
11. Van Gog T, Paas F, Van Merriënboer JJ. Process-oriented worked examples: improving transfer performance through enhanced understanding. Instr Sci 2004;32:83–98.
12. Nendaz MR, Bordage G. Promoting diagnostic problem representation. Med Educ 2002;36 (8):760–6.
13. Anderson JR. Cognitive Psychology and Its Implications. 3rd ed. A series of books in psychology. New York, NY, US: WH Freeman/Times Books/Henry Holt & Co 1990.
14. Audetat MC, Laurin S, Sanche G, Béïque C, Fon NC, Blais JG, Charlin B. Clinical reasoning difficulties: a taxonomy for clinical teachers. Med Teach 2013;35:e984–9.
15. Bordage G, Lemieux M. Semantic structures and diagnostic thinking of experts and novices. Acad Med 1991;66:S70–2.
16. Chang RW, Bordage G, Connell KJ. The importance of early problem representation during case presentations. Acad Med 1998;73:S109–11.
17. Fernandez N, Dory V, Ste-Marie L-G, Chaput M, Charlin B, Boucher A. Varying conceptions of competence: an analysis of how health sciences educators define competence. Med Educ 2012;46 (4):357–65.
18. Mamede S, van Gog T, Sampaio AM, de Faria RM, Maria JP, Schmidt HG. How can students’ diagnostic competence benefit most from practice with clinical cases? The effects of structured reflection on future diagnosis of the same and novel diseases. Acad Med 2014;89:121–7.
19. Kopp V, Stark R, Fischer MR. Fostering diagnostic knowledge through computer-supported, case-based worked examples: effects of erroneous examples and feedback. Med Educ 2008;42 (8):823–9.
20. Kopp V, Stark R, Kühne-Eversmann L, Fischer MR. Do worked examples foster medical students’ diagnostic knowledge of hyperthyroidism? Med Educ 2009;43 (12):1210–7.
21. Schmidt HG, Mamede S. How to improve the teaching of clinical reasoning: a narrative review and a proposal. Med Educ 2015;49 (10):961–73.
22. Gehlhar K, Klimke-Jung K, Stosch C, Fischer MR. Do different medical curricula influence self-assessed clinical thinking of students? GMS J Med Educ 2014;31:Doc23.
23. Bordage G, Grant J, Marsden P. Quantitative assessment of diagnostic ability. Med Educ 1990;24 (5):413–25.
24. Simonsohn AB, Fischer MR. Evaluation of a case-based computerized learning program (CASUS) for medical students during their clinical years. Dtsch Med Wochenschr 2004;129:552–6.
25. Kopp V, Möltner A. Key-feature-probleme zum prüfen von prozeduralem wissen: ein praxisleitfaden. Key feature problems for the assessment of procedural knowledge: a practical guide. GMS J Med Educ 2006;23:3.
26. Fischer MR, Kopp V, Holzer M, Ruderich F, Junger J. A modified electronic key feature examination for undergraduate medical students: validation threats and opportunities. Med Teach 2005;27:450–5.
27. Markant D, Gureckis TM. Does the utility of information influence sampling behavior? In Miyake N., Peebles D., Cooper R. P. (Eds.), Proceedings of the 34th Annual Conference of the Cognitive Science Society. Austin, TX: Cognitive Science Society 2012.
28. de Bruin AB, Schmidt HG, Rikers RM. The role of basic science knowledge and clinical knowledge in diagnostic reasoning: a structural equation modeling approach. Acad Med 2005;80:765–73.
29. Christiansen JM, Gerke O, Karstoft J, Andersen PE. Poor interpretation of chest X-rays by junior doctors. Dan Med J 2014;61:A4875.
30. Eisen LA, Berger JS, Hegde A, Schneider RF. Competency in chest radiography. A comparison of medical students, residents, and fellows. J Gen Intern Med 2006;21:460–5.