Contextual information influences diagnosis accuracy and decision making in simulated emergency medicine emergencies.
BMJ Qual Saf
; 22(6): 478-84, 2013 Jun.
Article
en En
| MEDLINE
| ID: mdl-23396852
BACKGROUND: It is well documented that adaptations in cognitive processes with increasing skill levels support decision making in multiple domains. We examined skill-based differences in cognitive processes in emergency medicine physicians, and whether performance was significantly influenced by the removal of contextual information related to a patient's medical history. METHOD: Skilled (n=9) and less skilled (n=9) emergency medicine physicians responded to high-fidelity simulated scenarios under high- and low-context information conditions. RESULTS: Skilled physicians demonstrated higher diagnostic accuracy irrespective of condition, and were less affected by the removal of context-specific information compared with less skilled physicians. The skilled physicians generated more options, and selected better quality options during diagnostic reasoning compared with less skilled counterparts. These cognitive processes were active irrespective of the level of context-specific information presented, although high-context information enhanced understanding of the patients' symptoms resulting in higher diagnostic accuracy. CONCLUSIONS: Our findings have implications for scenario design and the manipulation of contextual information during simulation training.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Evaluación de Procesos y Resultados en Atención de Salud
/
Médicos
/
Simulación de Paciente
/
Competencia Clínica
/
Toma de Decisiones
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
BMJ Qual Saf
Año:
2013
Tipo del documento:
Article
Pais de publicación:
Reino Unido