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Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging
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The effectiveness of cognitive forcing strategies to decrease diagnostic error: an exploratory study.

Jonathan Sherbino1, Steven Yip, Kelly L Dore

  • 1Division of Emergency Medicine, McMaster University, Hamilton, Ontario, Canada. sherbino@mcmaster.ca

Teaching and Learning in Medicine
|January 18, 2011
PubMed
Summary

Medical students showed poor application and retention of cognitive forcing strategies, a metacognition technique, in preventing diagnostic errors. Further research is needed to confirm its effectiveness in medical training.

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Area of Science:

  • Medical Education
  • Cognitive Psychology
  • Diagnostic Error

Background:

  • Cognitive forcing strategies, a metacognitive approach, are proposed to reduce diagnostic errors in medicine.
  • Medical training increasingly incorporates curricula for diagnostic error prevention.
  • Experimental evidence for the effectiveness of these curricula is currently lacking.

Purpose of the Study:

  • To explore the impact of cognitive forcing strategy training on diagnostic error.
  • To assess the initial application and retention of these strategies in medical students.

Main Methods:

  • An exploratory, prospective study enrolled 56 senior medical students during an emergency medicine rotation.
  • Students underwent interactive, standardized cognitive forcing strategy training.
  • A cross-over design evaluated 6 test cases for transfer between similar and novel diagnostic scenarios, with immediate or delayed testing (2 weeks).

Main Results:

  • Preliminary findings indicate poor application and retention of cognitive forcing strategies among participating medical students.
  • The study provides initial data on the effectiveness of such training in a real-world medical setting.

Conclusions:

  • This study is the first to investigate cognitive forcing strategy training's effect on diagnostic error.
  • Poor application and retention suggest limitations in current training approaches.
  • Further large-scale studies are necessary to determine if transfer of these strategies across different diagnostic formats is achievable.