METACOGNITIVE SCAFFOLDS IMPROVE SELF-JUDGMENTS OF ACCURACY IN A MEDICAL INTELLIGENT TUTORING SYSTEM

Area of Science:

• Medical Education
• Dermatopathology
• Cognitive Science

Background:

• Accurate confidence judgments are crucial for medical diagnosis.
• Metacognitive scaffolds can potentially improve diagnostic accuracy and self-assessment.
• The domain of Nodular and Diffuse Dermatitides presents diagnostic challenges.

Purpose of the Study:

• To evaluate the impact of two metacognitive scaffolds (Considering Alternatives and Playback) on confidence judgment accuracy in dermatopathology diagnosis.
• To compare the effectiveness of these scaffolds in improving diagnostic skills and metacognitive performance among residents.

Main Methods:

• Thirty-one pathology and dermatology residents were randomly assigned to either the Considering Alternatives or Playback condition.
• Participants used SlideTutor with initial feedback, followed by a two-hour scaffolding period without immediate feedback.
• Learning gains (pre/post-test) and metacognitive performance (bias, discrimination) were measured.

Main Results:

• Both groups showed significant improvement in diagnostic scores from pre-test to post-test.
• Participants in the Considering Alternatives condition demonstrated superior accuracy in confidence judgments.
• The Considering Alternatives group also showed better discrimination of correct versus incorrect diagnostic assertions.

Conclusions:

• The Considering Alternatives scaffold enhances metacognitive accuracy in confidence judgments for dermatopathology diagnosis.
• Visualizing diagnostic decision paths aids residents in becoming more aware of their diagnostic process.
• Metacognitive training strategies are valuable for improving diagnostic skills in medical trainees.