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Teaching metacognition in clinical decision-making using a novel mnemonic checklist: an exploratory study
Keng Sheng Chew1, Steven J Durning2, Jeroen Jg van Merriënboer3
1Formerly from the School of Medical Sciences, Universiti Sains Malaysia, Malaysia.
Singapore Medical Journal
|January 19, 2016
Summary
The TWED checklist significantly improved medical students' clinical decision-making skills by enhancing metacognition. This tool aids clinicians in reflecting on their thought processes for better patient care.
Area of Science:
- Medical Education
- Cognitive Science
- Clinical Decision-Making
Background:
- Metacognition is a crucial cognitive debiasing strategy for clinicians.
- Effective metacognition is vital for sound clinical decision-making.
- The TWED (Threat, What else, Evidence, Dispositional factors) checklist aids metacognition.
Purpose of the Study:
- To investigate the efficacy of the TWED checklist in improving medical students' clinical decision-making.
- To determine if the TWED checklist enhances metacognitive abilities in a clinical context.
Main Methods:
- A quasi-experimental study involving final-year medical students.
- Intervention group received TWED checklist training; control group received electrocardiography tutorial.
- Clinical decision-making assessed via five case scenarios post-intervention.
Main Results:
- The TWED intervention group achieved significantly higher mean scores (18.50 ± 4.45) than the control group (12.50 ± 2.84; p < 0.001).
- Students using the TWED checklist outperformed the control group in three out of five case scenarios.
Conclusions:
- The TWED checklist effectively facilitates metacognition in clinical decision-making.
- Findings support the integration of the TWED checklist into medical education to enhance diagnostic and treatment planning skills.
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