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Objectives Medical expertise manifests itself by the ability of a physician to rapidly diagnose patients. How this expertise develops from a neural-activation perspective is not well understood. The objective of the present study was to investigate practice-related activation changes in the prefrontal cortex (PFC) as medical students learn to diagnose chest X-rays. Methods The experimental paradigm consisted of a learning and a test phase. During the learning phase, 26 medical students were trained to diagnose four out of eight chest X-rays. These four cases were presented repeatedly and corrective feedback was provided. During the test phase, all eight cases were presented together with near- and far-transfer cases to examine whether participants’ diagnostic learning went beyond simple rote recognition of the trained X-rays. During both phases, participants’ PFC was scanned using functional near-infrared spectroscopy. Response time and diagnostic accuracy were recorded as behavioural indicators. One-way repeated measures ANOVA were conducted to analyse the data. Results Results revealed that participants’ diagnostic accuracy significantly increased during the learning phase (F=6.72, p Conclusions The results suggest that learning to diagnose X-rays is associated with a significant decrease in PFC activity. In terms of dual-process theory, these findings support the notion that students initially rely more on slow analytical system-2 reasoning. As expertise develops, system-2 reasoning transitions into faster and automatic system-1 reasoning. |
