A web exercise in evidence-based medicine using cognitive theory

Our aim was to improve clinical reasoning skills by applying an established theory of memory, cognition, and decision making (fuzzy-trace theory) to instruction in evidence-based medicine. Decision-making tasks concerning chest pain evaluation in women were developed for medical students and internal medicine residents. The fuzzy-trace theory guided the selection of online sources (e.g., target articles) and decision-making tasks. Twelve students and 22 internal medicine residents attended didactic conferences emphasizing search, evaluation, and clinical application of relevant evidence. A 17-item Likert scale questionnaire assessed participants' evaluation of the instruction. Ratings for each of the 17 items differed significantly from chance in favor of this alternative approach to instruction. We concluded that fuzzy-trace theory may be a useful guide for developing learning exercises in evidence-based medicine.