Case representation by medical experts, intermediates and novices for laboratory data presented with or without a clinical context.

P.P.J.L. Verkoeijen*, R.M.J.P. Rikers, H.G. Schmidt, M.W.J. van de Wiel, J.P. Kooman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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BACKGROUND: Based on cognitive psychological research, a number of theoretical frameworks have been put forward to describe the structure of experts' medical knowledge and to explain experts' case-processing.

PURPOSE: To provide evidence for the theory of knowledge encapsulation, which states that medical knowledge constitutes of interlinked biomedical and clinical knowledge.

METHODS: Fourth-year medical students, clerks and medical experts evaluated six case descriptions, consisting of laboratory data either with or without a clinical context. For each case description, the participants were required to study the case, to formulate a diagnosis, and to write down everything they could remember of the case.

RESULTS: When the laboratory data were not embedded within a clinical context, medical experts' case-processing increased and their diagnostic accuracy became worse. Furthermore, laboratory data recall of medical experts was more elaborate in cases where the laboratory data were presented without a clinical context. Similar results were obtained for students and clerks.

CONCLUSIONS: The findings are only partially consistent with a prediction made by the theory of knowledge encapsulation. Further research, using a different paradigm than the traditionally used method of free recall, is required to unearth whether medical experts use qualitatively different knowledge structures than novices while solving cases.

PMID: 15189258 [PubMed - indexed for MEDLINE]

MeSH TermsMeSH Terms:
Clinical Competence/standards
Diagnostic Techniques and Procedures/standards*
Education, Medical/methods
Medical History Taking/standards*
Mental Processes
Mental Recall
Physicians, Family/standards*
Problem Solving*
Students, Medical
LinkOut - more resourcesFull Text Sources:
Blackwell Publishing
Ingenta plc
OhioLINK Electronic Journal Center
Ovid Technologies, Inc.
Swets Information Services
Family History - MedlinePlus Health Information
Original languageEnglish
Pages (from-to)617-627
JournalMedical Education
Publication statusPublished - 1 Jan 2004

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