4.5 Article

Checklists improve experts' diagnostic decisions

Journal

MEDICAL EDUCATION
Volume 47, Issue 3, Pages 301-308

Publisher

WILEY
DOI: 10.1111/medu.12080

Keywords

-

Funding

  1. Ho Ping Kong Center for Excellence in Education and Practice

Ask authors/readers for more resources

Context Checklists are commonly proposed tools to reduce error. However, when applied by experts, checklists have the potential to increase cognitive load and result in expertise reversal'. One potential solution is to use checklists in the verification stage, rather than in the initial interpretation stage of diagnostic decisions. This may avoid expertise reversal by preserving the experts' initial approach. Whether checklist use during the verification stage of diagnostic decision making improves experts' diagnostic decisions is unknown. Methods Fifteen experts interpreted 18 electrocardiograms (ECGs) in four different conditions: undirected interpretation; verification without a checklist; verification with a checklist, and interpretation combined with verification with a checklist. Outcomes included the number of errors, cognitive load, interpretation time and interpretation length. Outcomes were compared in two analyses: (i) a comparison of verification conditions with and without a checklist, and (ii) a comparison of all four conditions. Standardised scores for each outcome were used to calculate the efficiency of a checklist and to weigh its relative benefit against its relative cost in terms of cognitive load imposed, interpretation time and interpretation length. Results In both analyses, checklist use was found to reduce error (more errors were corrected in verification conditions with checklists [0.29 +/- 0.77 versus 0.03 +/- 0.61 errors per ECG], and fewer net errors occurred in all conditions with checklists [0.39 +/- 1.14 versus 1.04 +/- 1.49 errors per ECG]; p<0.01 for both). Checklists were not associated with increased cognitive load (verifications with and without checklists: 3.7 +/- 1.9 and 3.3 +/- 2.0, respectively; conditions with and without checklists: 4.0 +/- 1.8 versus 3.9 +/- 2.0, respectively [p=not significant for both]). Checklists resulted in greater interpretation times and lengths (p<0.01 for all). However, checklists were efficient in terms of the cognitive load invested, interpretation time and interpretation length (p<0.01 for all). Conclusions Among ECG interpretation experts, checklist use during the verification stage of diagnostic decisions did not increase cognitive load or cause expertise reversal, but did reduce diagnostic error.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.5
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

Article Obstetrics & Gynecology

Effects of an in situ instructional design based postpartum hemorrhage simulation training on patient outcomes: an uncontrolled before-and-after study

Brena Carvalho Pinto de Melo, Cees P. M. Van der Vleuten, Arno M. M. Muijtjens, Ana Rodrigues Falbo, Leila Katz, Jeroen J. G. Van Merrienboer

Summary: This study compared the outcomes of postpartum hemorrhage (PPH) patients before and after in situ instructional design (ID) based PPH simulation training attended by obstetrics and gynecology (OBGYN) residents. The results showed an increase in the mean dosage of oxytocin after the simulation, indicating potential improvement in situational awareness in managing women with PPH.

JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE (2021)

Article Surgery

Validity of a low-cost Lichtenstein open inguinal hernia repair simulation model for surgical training

T. Nazari, M. P. Simons, M. H. Zeb, J. J. G. van Merrienboer, J. F. Lange, T. Wiggers, D. R. Farley

HERNIA (2020)

Article Education, Scientific Disciplines

Entrustable Professional Activities for Small-Group Facilitation: A Validation Study Using Modified Delphi Technique

Muhammad Zafar Iqbal, Karen D. Konings, Mohamed M. Al-Eraky, Jeroen J. G. van Merrienboer

Summary: This study evaluated a novel approach using entrustable professional activities (EPAs) for training and entrustment of small-group facilitators through a modified Delphi technique. Three out of nine proposed EPAs were retained, along with nine out of twelve predetermined competencies mapped against them. The final framework delineates three EPAs for small-group facilitation and their associated sub-activities, which can be useful for program developers, administrative bodies, and teaching staff.

TEACHING AND LEARNING IN MEDICINE (2021)

Article Education & Educational Research

It's about time to involve all stakeholders in co-creating faculty development programmes-Exploring the perceptions of students and teachers

Muhammad Zafar Iqbal, Karen D. Konings, Mohamed M. Al-Eraky, Jeroen J. G. van Merrienboer

Summary: Co-creating faculty development courses or activities through student-teacher partnership is a promising educational advancement with challenges. This study explores the perceptions of students and teachers regarding their experiences as co-creators of a faculty development program and examines ways to improve student-teacher partnership in future co-creation activities. Despite some negative factors, participants mostly view their co-creation experiences positively.

INNOVATIONS IN EDUCATION AND TEACHING INTERNATIONAL (2023)

Article Education & Educational Research

Development of a questionnaire to measure teachers' student-centred perspectives based on the Onion Model

Lukas Daniel Leatemia, Jeroen J. G. van Merrienboer, Astrid Pratidina Susilo

Summary: This study developed a reliable and valid instrument, the Student-Centred Perspective of Teachers (SCPT) questionnaire, to measure teaching perspectives. The results showed evidence of both internal and external validity for the SCPT.

BMC MEDICAL EDUCATION (2022)

Review Environmental Sciences

Understanding Feedback for Learners in Interprofessional Settings: A Scoping Review

Varun Coelho, Andrew Scott, Elif Bilgic, Amy Keuhl, Matthew Sibbald

Summary: Learner's perception and interaction with interprofessional feedback can affect the feedback process, highlighting the need for training. The perception and professions of feedback providers also play a role in the feedback process. Further research is needed to address barriers in feedback interaction that stem from misguided perceptions of feedback providers' professions.

INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH (2022)

Article Education & Educational Research

Identifying indicators to guide adaptive scaffolding in games

Tjitske J. E. Faber, Mary E. W. Dankbaar, Rob Kickert, Walter W. van den Broek, Jeroen J. G. van Merrienboer

Summary: In game-based learning, adaptive scaffolding can improve the learning of specific skills and self-regulation. We investigated the relationship between performance and self-regulation indicators and overall game performance in a medical emergency simulation game. Valid indicators for adaptive first-order and second-order scaffolding were identified. These indicators can be incorporated into future algorithms for adaptive scaffolding in game-based learning.

LEARNING AND INSTRUCTION (2022)

Article Education & Educational Research

Developing student-centred perspectives in PBL: how teacher profiles reveal educational needs for faculty development programmes

Lukas Daniel Leatemia, Astrid Pratidina Susilo, Jeroen Donkers, Jeroen J. G. van Merrienboer

Summary: This study aimed to identify teacher profiles that would reveal their specific educational needs and investigate the relationship between these profiles and the amount of PBL training. The findings showed that current faculty development programmes are not tailored to teachers' needs and suggested a redesign to promote student-centred perspectives more effectively.

BMC MEDICAL EDUCATION (2023)

Article Education, Scientific Disciplines

The Balancing Act of Assessment Validity in Interprofessional Healthcare Education: A Qualitative Evaluation Study

Hester Wilhelmina Henrica Smeets, Laurie E. C. Delnoij, Dominique M. A. Sluijsmans, Albine Moser, Jeroen J. G. van Merrienboer

Summary: This study evaluates the evidence for and threats to the validity of an interprofessional assessment task. The findings suggest that establishing interprofessional assessment validity requires a balance between authenticity and complexity, authenticity and scoring, and team scoring and individual scoring. Ongoing evaluation and monitoring are necessary to ensure authentic yet fair assessments for all participating professions.

TEACHING AND LEARNING IN MEDICINE (2023)

Article Education, Scientific Disciplines

Design guidelines for assessing students' interprofessional competencies in healthcare education: a consensus study

Hester Wilhelmina Henrica Smeets, Dominique M. A. Sluijsmans, Albine Moser, Jeroen J. G. van Merrienboer

Summary: This study aims to provide guidelines for the assessment of IP competencies in healthcare education, resulting in 26 comprehensive guidelines for the design of IP assessments. The results showed that IP assessments are more complex than mono-professional assessments, requiring additional elements for high-quality assessments.

PERSPECTIVES ON MEDICAL EDUCATION (2022)

Article Education & Educational Research

Understanding self-regulated learning through the lens of motivation: Motivational regulation strategies vary with students' motives

Daria I. Ilishkina, Anique de Bruin, Andrey Podolskiy, Marina Volk, Jeroen J. G. van Merrienboer

Summary: Successful learners should self-regulate their motivation to learn. By being aware of the intrinsic and extrinsic motives to learn, they can choose appropriate motivational regulation strategies.

INTERNATIONAL JOURNAL OF EDUCATIONAL RESEARCH (2022)

Article Education & Educational Research

Student, direct thyself! Facilitating self-directed learning skills and motivation with an electronic development portfolio

Jorrick Beckers, Diana Dolmans, Jeroen van Merrienboer

Summary: The study found that using an electronic development portfolio with teacher-guided student self-coaching can enhance students' self-directed learning skills and motivation, leading to higher levels of self-direction, intrinsic goal orientation, and self-efficacy in students.

JOURNAL OF RESEARCH ON TECHNOLOGY IN EDUCATION (2022)

Article Education & Educational Research

Stimulating the intention to change learning strategies: The role of narratives

Luotong Hui, Anique B. H. de Bruin, Jeroen Donkers, Jeroen J. G. van Merrienboer

Summary: The study suggests that compared to traditional didactic communication, narratives can better help students understand learning strategies, inspire them to change ineffective strategies, and enhance awareness of the importance of desirable difficulties in learning.

INTERNATIONAL JOURNAL OF EDUCATIONAL RESEARCH (2021)

Article Education & Educational Research

How isolation of key information and allowing clarifying questions may improve information quality and diagnostic accuracy at case handover in paediatrics

T. Balslev, A. Muijtjens, W. de Grave, H. Awneh, J. van Merrienboer

Summary: Structured handover based on cognitive load theory can improve information quality and diagnostic accuracy, but may prolong handover duration.

ADVANCES IN HEALTH SCIENCES EDUCATION (2021)

Article Education & Educational Research

Development of an entrustable professional activities (EPAs) framework for small group facilitators through a participatory design approach

Muhammad Zafar Iqbal, Karen D. Konings, Mohamed Al-Eraky, Mona Hmoud AlSheikh, Jeroen J. G. van Merrienboer

MEDICAL EDUCATION ONLINE (2020)

No Data Available