gms | German Medical Science

Learning through Inquiry in Higher Education: Current Research and Future Challenges (INHERE 2018)

08.03. - 09.03.2018, München

Case representation scaffolds improve diagnostic efficiency in 4th-5th year medical students: a randomized controlled laboratory study

Meeting Abstract

  • corresponding author presenting/speaker Leah Braun - Klinikum der LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
  • author Jan Zottmann - Klinikum der LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
  • author Stefan Wirth - Klinikum der LMU München, Klinik und Poliklinik für Radiologie, Munich, Germany
  • author Martin Fischer - Klinikum der LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
  • author Ralf Schmidmaier - Klinikum der Universität München, Medizinische Klinik und Poliklinik IV, Munich, Germany

Learning through Inquiry in Higher Education: Current Research and Future Challenges (INHERE 2018). München, 08.-09.03.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. Doc37

doi: 10.3205/18inhere37, urn:nbn:de:0183-18inhere375

Published: March 1, 2018

© 2018 Braun et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Introduction: Understanding diagnostic competence and how it can be fostered is a major challenge in medical education research. Although different strategies to improve diagnostic accuracy have been investigated, little is known about students’ diagnostic efficiency operationalized as correct diagnoses per time. Following the theoretical bases, scaffolds for case representation could be a promising approach to make the diagnostic process of intermediate medical students more efficient. The aims of this study were to measure the effects of case representation scaffolding on the diagnostic efficiency and to investigate the diagnostic processes of medical students in an electronically based learning environment.

Methods: Clinical case processing of 88 4th and 5th year medical students was analyzed in a randomized, controlled laboratory study. Cases with medical encounter dyspnea were provided in an electronic learning environment (CASUS). Students could freely choose the time, amount and sequence of clinical information. Diagnostic efficiency was operationalized as the number of correct diagnoses divided by the time needed for diagnosing.

Results: During processing of the assessment cases efficiency was significantly improved by the representation scaffolding (M=20.8 minutes (SD=7.15), M=24.6 (SD=7.42), p=.01) with an intermediate effect size of Cohens d=0.5. The diagnostic accuracy, however, did not differ between both groups. CASUS enabled analysis of the diagnostic process of the participants which differed between the groups regarding the sequence of clinical information and the time spent on different diagnostics.

Discussion and Conclusion: For the first time, diagnostic efficiency as part of the diagnostic process of medical students has been studied economically and standardized by an electronic learning environment (CASUS). This provides the opportunity of further research in the area of the diagnostic process. Furthermore, intervention by scaffolding for case representations significantly improved diagnostic efficiency of 4th and 5th year medical students.