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Inducing expertise effects in clinical case recall.
Paul F Wimmers1, Henk G Schmidt, Peter P J L Verkoeijen
1Department of Psychology, Erasmus University, Rotterdam, the Netherlands. pwimmers@medschool.pitt.edu
Medical Education
|September 10, 2005
Summary
Medical students with intermediate expertise show a unique "intermediate effect" in clinical case recall. This study reveals that requiring elaboration on patient data, not just raw information, can trigger expertise effects in recall.
Area of Science:
- Cognitive Psychology
- Medical Education
- Expertise Studies
Background:
- The 'intermediate effect' describes how medical students of intermediate expertise outperform novices and experts in clinical case recall.
- This contrasts with some research suggesting a monotonic increase in recall with expertise level.
Purpose of the Study:
- To investigate the causes of the 'intermediate effect' in medical expertise.
- To experimentally demonstrate how data elaboration influences clinical case recall and expertise effects.
Main Methods:
- Expert nephrologists, intermediate students, and novices reviewed 6 medical cases.
- Three conditions were used: basic lab data, lab data with elaboration instructions, and lab data with clinical context.
Main Results:
- An expertise effect in case recall was observed only when participants were instructed to elaborate on information.
- The 'intermediate effect' emerged when laboratory data was presented within a patient's clinical history and physical examination context.
Conclusions:
- Elaboration instructions prompted deeper case analysis, particularly impacting expert recall.
- Expertise effects in clinical case recall may arise from disruptions to normal information processing routines.