Document Detail

A failure to reproduce the intermediate effect in clinical case recall.
MedLine Citation:
PMID:  9736850     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To investigate the differences between experts, intermediates, and novices in diagnosing and representing clinical cases under various time constraints. METHOD: Second-, fourth-, and sixth-year medical students, and internists studied, diagnosed, and recalled four clinical cases from internal medicine. Participants were allowed to study each case for either 3 minutes, 1 minute 15 seconds, or 30 seconds. The study replicated in most ways the 1993 clinical case recall study of Schmidt and Boshuizen. RESULTS: As expected, diagnostic accuracy increased with level of expertise. However, this study failed to disclose the intermediate effect in clinical case recall that was found in the original study. Instead, a positive linear relation between expertise level and case recall was found. The discrepancy resulted from more elaborate recall by experts in the present study. Constraining processing time did not effect diagnostic accuracy, but equally affected the recall performances of the participants of all expertise levels. This contrasts with the earlier finding that experts' recall is independent of processing time. CONCLUSION: Although it is unclear why the experts' case processing was more elaborate in the present study than in the earlier study, it must be concluded that expert medical knowledge is so flexibly organized that experts can easily represent clinical cases in either the encapsulated or the elaborated mode.
M W van de Wiel; H G Schmidt; H P Boshuizen
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Academic medicine : journal of the Association of American Medical Colleges     Volume:  73     ISSN:  1040-2446     ISO Abbreviation:  Acad Med     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1998-10-01     Completed Date:  1998-10-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8904605     Medline TA:  Acad Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  894-900     Citation Subset:  AIM; IM    
Skillslab, Faculty of Medicine, Maastricht University, Maastricht, The Netherlands.
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MeSH Terms
Analysis of Variance
Arteriosclerosis / diagnosis
Clinical Competence*
Diagnostic Errors / statistics & numerical data*
Heart Failure / diagnosis
Internship and Residency*
Liver Cirrhosis / diagnosis
Mental Recall*
Pheochromocytoma / diagnosis
Stomach Neoplasms / diagnosis
Students, Medical*
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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