gms | German Medical Science

4th Research in Medical Education (RIME) Symposium 2015

19.03-21.03.2015, München

Competency-based medical education: Certainty in evidence-based decision-making in own and other domain

Meeting Abstract

  • corresponding author presenting/speaker Mia Wermelt - Klinikum der LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
  • Andreas Hetmanek - LMU München, Lehrstuhl für Empirische Pädagogik und Pädagogische Psychologie, Munich, Germany
  • Christof Wecker - LMU München, Lehrstuhl für Empirische Pädagogik und Pädagogische Psychologie, Munich, Germany
  • Kati Trempler - Bergische Universität Wuppertal, Lehrstuhl für Lehr,- Lern- und Unterrichtsforschung in der School of Education, Wuppertal, Germany
  • Cornelia Gräsel - Bergische Universität Wuppertal, Lehrstuhl für Lehr,- Lern- und Unterrichtsforschung in der School of Education, Wuppertal, Germany
  • Frank Fischer - LMU München, Lehrstuhl für Empirische Pädagogik und Pädagogische Psychologie, Munich, Germany
  • Martin R. Fischer - Klinikum der LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
  • Jan Kiesewetter - Klinikum der LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany

4th Research in Medical Education (RIME) Symposium 2015. München, 19.-21.03.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocP35

doi: 10.3205/15rime46, urn:nbn:de:0183-15rime467

Veröffentlicht: 12. März 2015

© 2015 Wermelt et al.
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Gliederung

Text

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 Externer Link
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 Externer Link