Use of a structured approach and virtual simulation practice to improve diagnostic reasoning.

Authors

• Michael Dekhtyar
• Yoon Soo Park
• Judy Kalinyak
• Saumil M Chudgar
• Kelly Bossenbroek Fedoriw
• Khadeja J Johnson
• Craig F Knoche
• Lisa Martinez
• Nina Mingioni
• Amber T Pincavage
• Rachel Salas
• Fred Sanfilippo
• Stephen M Sozio
• Nancy Weigle
• Sarah Wood
• Jillian Zavodnick
• Scott Stern

Publication/Presentation Date

7-12-2021

Abstract

OBJECTIVES: In 2015, the National Academy of Medicine IOM estimated that 12 million patients were misdiagnosed annually. This suggests that despite prolonged training in medical school and residency there remains a need to improve diagnostic reasoning education. This study evaluates a new approach.

METHODS: A total of 285 medical students were enrolled in this 8 center, IRB approved trial. Students were randomized to receive training in either abdominal pain (AP) or loss of consciousness (LOC). Baseline diagnostic accuracy of the two different symptoms was assessed by completing a multiple-choice question (MCQ) examination and virtual patient encounters. Following a structured educational intervention, including a lecture on the diagnostic approach to that symptom and three virtual patient practice cases, each student was re-assessed.

RESULTS: The change in diagnostic accuracy on virtual patient encounters was compared between (1) baseline and post intervention and (2) post intervention students trained in the prescribed symptom vs. the alternate symptom (controls). The completeness of the student's differential diagnosis was also compared. Comparison of proportions were conducted using

CONCLUSIONS: The study showed that a virtual patient platform combined with a diagnostic reasoning framework could be used for education and diagnostic assessment and improved correct diagnosis compared with baseline performance in a simulated platform.

Volume

9

Issue

1

First Page

69

Last Page

76

ISSN

2194-802X

Published In/Presented At

Dekhtyar, M., Park, Y. S., Kalinyak, J., Chudgar, S. M., Fedoriw, K. B., Johnson, K. J., Knoche, C. F., Martinez, L., Mingioni, N., Pincavage, A. T., Salas, R., Sanfilippo, F., Sozio, S. M., Weigle, N., Wood, S., Zavodnick, J., & Stern, S. (2021). Use of a structured approach and virtual simulation practice to improve diagnostic reasoning. Diagnosis (Berlin, Germany), 9(1), 69–76. https://doi.org/10.1515/dx-2020-0160

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

34246202

Department(s)

Administration and Leadership

Document Type

Article