A mixed methods study comparing video based and paper based diagnostic error education for medical students

Diagnostic errors, which can negatively impact patient outcomes, require better prevention strategies. Simulated patient case studies can be useful educational tools for medical students to reduce diagnostic errors. We compared the effectiveness of video- and paper-based diagnostic error case studies as teaching modalities for medical students. In this mixed-method, non-blinded randomized controlled trial, we recruited Japanese medical students. The participants (N = 113) received either video- (n = 57) or paper-based (n = 56) materials presenting five diagnostic error cases of over 30-min duration. Knowledge about diagnostic errors, motivation, and provider responsibility beliefs of diagnostic errors were assessed pre- and post-intervention. Participants in the video-based group reported greater improvement in self-perceived knowledge about diagnostic errors compared with those in the paper-based group (mean change: 1.6 ± 1.9 vs. 0.9 ± 1.3; P = 0.019). However, after adjusting for baseline scores using analysis of covariance, no significant between-group difference was found. Seventeen themes and subcategories corresponding to the six cognitive process dimensions of Fink's taxonomy of significant learning were identified. The most prevalent themes related to immersive learning style, application of diagnostic error process, and considering diverse perspectives on diagnostic errors. Video-based instructions might promote more immersive learning experiences and enhance recognition of high-risk diseases and red-flag situations among medical students.