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Improving diagnostic capabilities of medical students via application of cognitive sciences-derived learning principles.

Papa FJ, Oglesby MW, Aldrich DG, Schaller F, Cipher DJ

University of North Texas Health Science Center, TX, USA. fpapa@hsc.unt.edu

PURPOSE: There is limited experimental evidence concerning how best to train students to perform differential diagnosis. We compared 2 different methods for training 2nd-year medical students to perform differential diagnosis (DDX) of heart failure: a traditional classroom-based lecture (control group) versus a cognitive sciences-based approach to DDX instruction implemented through a computer-based tutor (treatment group). METHODS: Following random assignment to either group, students were trained for 75 minutes, and then given a 40-item examination comprised of cases that varied along a typicality gradient from prototypical (easy) to less typical (hard). RESULTS: The treatment group diagnosed correctly significantly more test cases than the control group (74% versus 60%, respectively). The treatment group also diagnosed correctly significantly more cases at the extremes of the typicality gradient: 81% versus 65%, respectively, for the prototypical cases; 65% versus 48%, respectively, for the most difficult cases. CONCLUSION: The ability to perform differential diagnosis is enhanced by training based upon principles of cognitive sciences.

Published 13 April 2007 in Med Educ, 41(4): 419-25.
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