Artikel
Competency-based medical education: Certainty in evidence-based decision-making in own and other domain
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Veröffentlicht: | 12. März 2015 |
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Gliederung
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On PubMed alone, about one new reference is listed every minute [http://duncan.hull.name/2010/07/15/fifty-million/] – and there is a need for physicians to be able to handle this growing amount of new evidence in order to arrive at the most up-to-date, evidence-based decisions for each patient. To be able to train this competency, the ability to identify influencing variables of informed decisions is essential and one controversial confounder in decision-making research has been the certainty of personal judgment which is essential to avoid incorrect diagnoses and therapies [1]. We wanted to know how personal certainty in decision-making changes after students are confronted with ambiguous evidences.
Furthermore, we wanted to identify whether performance in evaluating scientific papers is a domain-specific competency.
Between Nov 6th and Dec 6th 2013, 165 medical students from LMU Munich edited a scenario from both the medical and educational domain, and made decisions before and after reading scientific papers on the subject. They rated the pertinence of these papers to their decision, which was correlated with an expert rating, as well as their personal certainty before and after reading the papers (self-assessment).
The medical students’ judgment of the papers’ pertinence was better for those in the educational than medical field (F(1,164)=31.98; η2=.16), whereas personal certainty significantly increased only after reading in the medical domain (F(1,163)=11.51; η2=.07).
The medical students were more easily able to judge the pertinence of the educational papers than the medical papers, which rather argues against a domain-specific ability to perform evidence-based decision-making. As self-assessed certainty increased with reading and evaluating scientific evidence, monitoring personal certainty seems to also be important for successful integration of teaching sessions on evidence-based decision-making [2].
References
- 1.
- Mann D. The relationship between diagnostic accuracy and confidence in medical students. Atlanta: American Educational Research Association; 1993. Available from: http://files.eric.ed.gov/fulltext/ED358110.pdf
- 2.
- Cavalcanti RB, Sibbald M. Am I Right When I Am Sure? Data Consistency Influences the Relationship Between Diagnostic Accuracy and Certainty. Acad Med. 2014;89(1):107–113. DOI: 10.1097/ACM.0000000000000074