Clinical Reasoning, Diagnostic Uncertainty, Evidence Based Medicine, Pulmonary Embolism, Visualization of Uncertainty
Conditions
Keywords
randomized controlled study
Brief summary
Medical reasoning is a form of inquiry that examines the thought processes involved in making medical decisions. When physicians are faced with patients' symptoms or signs, their thought processes follow either direct shortcuts to suspect a diagnosis or go into a deeper and more analytic process to reach a diagnosis. The second pathway is less prone to biases and errors. This study explores whether the use of an interactive visual display of probabilities of pulmonary embolism generated from positive or negative test results will increase the adherence to evidence based guidelines in the diagnosis of pulmonary embolism.
Interventions
OTHERVisualized pulmonary embolism computer task model
This group of participants was presented and trained to use a visual representation of diagnostic pathway for pulmonary embolism. The design of this visual representation is based on Bayes theorem and cognition enhancing visual design principles.
OTHERDidactic review lecture
This group of participants was presented with a didactic lecture covering the diagnostic approach of pulmonary embolism.
Sponsors
University of Calgary
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
24 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Medical students, University of Calgary, in clerkship who finished at least 4 weeks of a block of medicine rotation at any hospital site. * First year subspecialty or Internal Medicine residents. * Practicing physicians in the subspecialties of Internal Medicine or Emergency Medicine.
Exclusion criteria
* Physicians in the subspecialty of Haematology or Respiratory
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Concordance with medical diagnostic reasoning pathway for pulmonary embolism. | Paper-based clinical case scenarios were completed within 2 hour after either intervention. | Concordance with medical diagnostic reasoning pathway for a case presentation suggestive of pulmonary embolism will be reflected by whether participants are stopping prematurely or proceeding with diagnostic steps inappropriately. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time. | Paper-based clinical case scenarios were completed within 2 hour after either intervention. | The overall time taken to solve each clinical scenario may give insight to which decision making process was predominant to solve each clinical scenario. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Survey. | Survey was completed within 2 hours after completion of either intervention. | The participants' responses to the satisfaction survey will provide feedback about the need for improvement or modification in interface of software |
Countries
Canada
Outcome results
None listed