Improving Medical Residents' Self-Assessment of Their Diagnostic Accuracy: Does Feedback Help?

Autor/inn/en	Kuhn, Josepha; van den Berg, Pieter; Mamede, Silvia; Zwaan, Laura; Bindels, Patrick; van Gog, Tamara
Titel	Improving Medical Residents' Self-Assessment of Their Diagnostic Accuracy: Does Feedback Help?
Quelle	In: Advances in Health Sciences Education, 27 (2022) 1, S.189-200 (12 Seiten)Infoseite zur Zeitschrift PDF als Volltext Verfügbarkeit
Zusatzinformation	ORCID (Kuhn, Josepha)
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	1382-4996
DOI	10.1007/s10459-021-10080-9
Schlagwörter	Graduate Medical Education; Graduate Students; Medical Students; Clinical Diagnosis; Accuracy; Feedback (Response); Program Effectiveness + Suchen Sie Ihr Suchwort? Graduate Study; Student; Students; Aufbaustudium; Graduiertenstudium; Hauptstudium; Studentin
Abstract	When physicians do not estimate their diagnostic accuracy correctly, i.e. show inaccurate "diagnostic calibration," diagnostic errors or overtesting can occur. A previous study showed that physicians' diagnostic calibration for easy cases improved, after they received feedback on their previous diagnoses. We investigated whether diagnostic calibration would also improve from this feedback when cases were more difficult. Sixty-nine general-practice residents were randomly assigned to one of two conditions. In the feedback condition, they diagnosed a case, rated their confidence in their diagnosis, their invested mental effort, and case complexity, and then were shown the correct diagnosis (feedback). This was repeated for 12 cases. Participants in the control condition did the same without receiving feedback. We analysed calibration in terms of (1) absolute accuracy (absolute difference between diagnostic accuracy and confidence), and (2) bias (confidence minus diagnostic calibration). There was no difference between the conditions in the measurements of calibration (absolute accuracy, p = 0.204; bias, p = 0.176). Post-hoc analyses showed that on correctly diagnosed cases (on which participants are either accurate or underconfident), calibration in the feedback condition was less accurate than in the control condition, p = 0.013. This study shows that feedback on diagnostic performance did not improve physicians' calibration for more difficult cases. One explanation could be that participants were confronted with their mistakes and thereafter lowered their confidence ratings even if cases were diagnosed correctly. This shows how difficult it is to improve diagnostic calibration, which is important to prevent diagnostic errors or maltreatment. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2024/1/01