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Adding guidance to deliberate reflection improves medical student's diagnostic accuracy.
Rachel Aparecida Ferreira Fernandes1, Leandro Fernandes Malloy-Diniz2, Marcos Carvalho de Vasconcellos1
1Department of Pediatrics, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Medical Education
|May 12, 2021
Summary
Adding instructional guidelines to prompt deliberate reflection significantly improved medical students' diagnostic accuracy. This benefit persisted for simple cases in delayed testing and for complex cases in senior students.
Area of Science:
- Medical Education
- Diagnostic Reasoning
- Cognitive Psychology
Background:
- Diagnostic competence is a key goal in medical education.
- Deliberate reflection, guided by instructional strategies, enhances diagnostic skills.
- This study examines the impact of guided reflection on diagnostic accuracy across different clinical case complexities and student levels.
Purpose of the Study:
- To evaluate the effectiveness of instructional guidelines promoting deliberate reflection on medical students' diagnostic accuracy.
- To compare the impact of different reflection strategies (free, cued, worked example) on diagnostic performance.
- To assess how case complexity and student seniority influence the benefits of these teaching strategies.
Main Methods:
- Eighty third-year and 62 sixth-year medical students participated in a three-phase experimental study.
- Participants were assigned to free reflection, cued reflection, or worked example conditions.
- Diagnostic accuracy was assessed through immediate and delayed tests involving clinical cases of varying complexity and disease rarity.
Main Results:
- Experimental condition, year of training, and study phase significantly affected diagnostic accuracy.
- Deliberate reflection with instructional guidelines improved immediate test accuracy for all students.
- In delayed tests, reflection benefits persisted for simple cases but were limited to senior students for complex cases.
Conclusions:
- Instructional guidelines fostering deliberate reflection enhance diagnostic accuracy in medical students.
- The effectiveness of reflection strategies varies with case complexity and student experience level.
- Cued reflection and worked examples are more effective than free reflection for improving diagnostic skills.
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