Abstract:
BACKGROUND:Quite often medical students or novice residents have difficulty in ruling out diseases even though they are quite unlikely and, due to this difficulty, such students and novice residents unnecessarily repeat laboratory or imaging tests. OBJECTIVE:To explore whether or not a carefully designed short training course teaching Bayesian probabilistic thinking improves the diagnostic ability of medical students. PARTICIPANTS AND METHODS:Ninety students at 2 medical schools were presented with clinical scenarios of coronary artery disease corresponding to high, low, and intermediate pretest probabilities. The students' estimates of test characteristics of exercise stress test, and pretest and posttest probability for each scenario were evaluated before and after the short course. RESULTS:The pretest probability estimates by the students, as well as their proficiency in applying Bayes's theorem, were improved in the high pretest probability scenario after the short course. However, estimates of pretest probability in the low pretest probability scenario, and their proficiency in applying Bayes's theorem in the intermediate and low pretest probability scenarios, showed essentially no improvement. CONCLUSION:A carefully designed, but traditionally administered, short course could not improve the students' abilities in estimating pretest probability in a low pretest probability setting, and subsequently students remained incompetent in ruling out disease. We need to develop educational methods that cultivate a well-balanced clinical sense to enable students to choose a suitable diagnostic strategy as needed in a clinical setting without being one-sided to the "rule-in conscious paradigm."
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Noguchi Y,Matsui K,Imura H,Kiyota M,Fukui Tdoi
10.1111/j.1525-1497.2004.30257.xsubject
Has Abstractpub_date
2004-05-01 00:00:00pages
427-32issue
5 Pt 1eissn
0884-8734issn
1525-1497pii
JGI30257journal_volume
19pub_type
杂志文章abstract:BACKGROUND:Workforce projections indicate a potential shortage of up to 31,000 adult primary care providers by the year 2025. Approximately 80 % of internal medicine residents and nearly two-thirds of primary care internal medicine residents do not plan to have a career in primary care or general internal medicine. OB...
journal_title:Journal of general internal medicine
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pub_type: 杂志文章,多中心研究,随机对照试验
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