gms | German Medical Science

Fostering diagnostic competence and error detection skills are important for diagnostic accuracy in medicine. Teaching these skills is difficult but essential for medical education. Doctors and medical students regularly face problems when performing accurate diagnoses, even with increased expertise. Cognitive modeling shows great promise to foster learning of such competences [1]. In the present study this involved observing a peer perform a cognitive task while explaining the rationale behind it. To increase elaboration of the observed performance, errors can be built into the example [3]. Providing peer feedback on these errors seems promising to increase error detection and elaboration [2]. A video based intervention was created on the basis of erroneous cognitive modeling and implemented in a seminar for advanced medical students in the clinical part of their studies. The students provided feedback to a video-taped peer student performing a differential diagnosis of the guiding symptom dyspnea. The study was designed as a 2x2 design with the following factors:

1.

(Students either had to provide feedback to the peers in the video or just watched the videos, and

2.

the videos they watched showed erroneous versus correct diagnoses.

A control group was instructed to learn from a textbook how to diagnose and was compared to the four modeling conditions. Thus far, a pilot study has been conducted (N=12). The main study (N=160) is ongoing and will be finalized in January 2015. Results of the pilot revealed a positive relationship between the quality of peer feedback and diagnostic competence after working with the erroneous modeling examples. Additionally, a comparison between erroneous and correct diagnoses showed that providing peer feedback on observed erroneous diagnoses seems to foster error detection skills in a transfer task.