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Using computerized virtual cases to explore diagnostic error in practicing physicians.

Robert L Trowbridge1,2, James B Reilly3,4, Jerome C Clauser5

  • 1Department of Medicine, Maine Medical Center, 22 Bramhall Street, Portland, ME 04102, USA, Phone: +(207) 662-4618.

Diagnosis (Berlin, Germany)
|September 13, 2018
PubMed
Summary
This summary is machine-generated.

Computerized virtual patients offer a safe way to study clinical reasoning, but current platforms present challenges for practicing physicians. Developing effective virtual cases requires significant resources and adaptive features to accurately reflect real-world diagnostic processes.

Keywords:
cognitive biasdiagnostic errorvirtual cases

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Area of Science:

  • Medical Education
  • Cognitive Science
  • Health Informatics

Background:

  • Diagnostic errors are a major source of patient harm.
  • Cognitive factors significantly contribute to diagnostic errors.
  • Studying and mitigating diagnostic errors is challenging.

Purpose of the Study:

  • To assess the feasibility and utility of computerized virtual patients for studying diagnostic errors in practicing physicians.
  • To explore the impact of virtual patient platforms on physician diagnostic performance.

Main Methods:

  • Development of computerized virtual cases with contextual factors for diagnostic error.
  • Piloting cases with practicing physicians in two phases.
  • Recording participant impressions and physician performance outcome data.

Main Results:

  • Physicians encountered challenges with the virtual case platform, including unfamiliarity and rigid processes.
  • Correct diagnoses were identified in less than 33% of cases.
  • Participants found cases to be typical of common clinical presentations.

Conclusions:

  • Developing effective virtual patient cases requires substantial resources and adaptive platforms.
  • Non-adaptive platforms may negatively impact diagnostic performance and increase cognitive load.
  • Virtual cases hold potential as a safe method for studying clinical reasoning.