The influence of ‘deliberate’ implementation intention on medical students’ risk decision task outcomes

BackgroundDiagnostic errors can have tremendous consequences because they can result in a fatal chain of wrong decisions. Experts assume that physicians' desire to confirm a preliminary diagnosis while failing to seek contradictory evidence is an important reason for wrong diagnoses. This tendency is called ‘confirmation bias’.MethodTo study whether psychiatrists and medical students are prone to confirmation bias and whether confirmation bias leads to poor diagnostic accuracy in psychiatry, we presented an experimental decision task to 75 psychiatrists and 75 medical students.ResultsA total of 13% of psychiatrists and 25% of students showed confirmation bias when searching for new information after having made a preliminary diagnosis. Participants conducting a confirmatory information search were significantly less likely to make the correct diagnosis compared to participants searching in a disconfirmatory or balanced way [multiple logistic regression: odds ratio (OR) 7.3, 95% confidence interval (CI) 2.53–21.22, p<0.001; OR 3.2, 95% CI 1.23–8.56, p=0.02]. Psychiatrists conducting a confirmatory search made a wrong diagnosis in 70% of the cases compared to 27% or 47% for a disconfirmatory or balanced information search (students: 63, 26 and 27%). Participants choosing the wrong diagnosis also prescribed different treatment options compared with participants choosing the correct diagnosis.ConclusionsConfirmatory information search harbors the risk of wrong diagnostic decisions. Psychiatrists should be aware of confirmation bias and instructed in techniques to reduce bias.

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Cognitive E-Tools for Diagnosing the State of Medical Knowledge in Students Enrolled for a Second Time in an Anatomy Course

International Journal of Learning Teaching and Educational Research ◽

10.26803/ijlter.19.9.18 ◽

2020 ◽

Vol 19 (9) ◽

pp. 341-362

Author(s):

Guadalupe Elizabeth Morales-Martinez ◽

Alberto Manuel Ángeles Castellanos ◽

Víctor Hugo Ibarra Ramírez ◽

Magaly Iveth Mancera Rangel

Keyword(s):

Medical Students ◽

Evaluation Model ◽

Computational Simulation ◽

Medical Knowledge ◽

Cognitive Learning ◽

Semantic Networks ◽

Decision Task ◽

Cognitive Approach ◽

Temporal Properties ◽

First Year Medical Students

This article illustrates the application of the Chronometric Constructive Cognitive Learning Evaluation Model to measure the structural, organizational, and temporal properties of the anatomical knowledge schemata acquired by 52 first-year medical students enrolled for a second time in an anatomy course. The participants took part in a mental representation experiment as a part of which they carried out a conceptual definition task involving anatomy concepts based on the Natural Semantic Networks (NSN) technique. A computational simulation was performed on the NSN data, after which the students took part in a semantic priming experiment involving a lexical decision task which required them to classify words related or unrelated to their anatomy schema as word/non-word. Findings revealed that, although students stored the anatomy information in their memory, they struggled to structure, consolidate, and retrieve this information from their memory. These findings suggest that students who did not get the passing grade in anatomy course may struggle with integrating and consolidating pertinent information. Thus, results showed that the constructive-chronometric cognitive approach is useful to measure the properties of schemes medical students developed on the anatomy topic.

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