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Related Experiment Videos

The difficulty with experience: does practice increase susceptibility to premature closure?

Kevin W Eva1, John P W Cunnington

  • 1Department of Clinical Epidemiology and Biosta-tistics, Program for Educational Research and Development, McMaster University, Hamilton, Ontario, Canada. evakw@mcmaster.ca

The Journal of Continuing Education in the Health Professions
|September 21, 2006
PubMed
Summary

Experienced physicians may excessively rely on initial diagnostic impressions, a cognitive tendency that can be mitigated through targeted continuing education. This study investigated how information order impacts diagnostic probability judgments in physicians of varying experience levels.

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Area of Science:

  • Cognitive Psychology
  • Medical Education
  • Physician Performance

Background:

  • Physician performance literature suggests diagnostic search closure risk increases with experience.
  • Understanding cognitive factors in medical diagnosis is crucial for effective continuing education.

Purpose of the Study:

  • To test the hypothesis that diagnostic search closure risk increases with physician experience.
  • To investigate the impact of information order on diagnostic probability judgments.
  • To explore cognitive tendencies relevant to continuing medical education.

Main Methods:

  • Physicians evaluated case histories, judging the probability of paired diagnoses.
  • Information order was manipulated to assess its effect on diagnostic probability.

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  • Participants were divided into two age groups: younger and older than 60 years.
  • Main Results:

    • Information order significantly influenced diagnostic probability assignments.
    • A primacy effect was observed, where initial information had a greater impact.
    • Older, more experienced physicians exhibited a stronger primacy effect than less experienced counterparts.

    Conclusions:

    • Greater physician experience correlates with increased reliance on initial diagnostic impressions.
    • Instructional design for continuing medical education should address experience-specific cognitive biases.
    • Mitigating premature diagnostic closure requires awareness of how information order influences experienced clinicians.