Why patients' disruptive behaviours impair diagnostic reasoning: a randomised experiment
| Autor: | Mamede, Sílvia, Van Gog, Tamara, Schuit, Stephanie C.E., Van Den Berge, Kees, Van Daele, Paul L.A., Bueving, Herman, Zee, Tim, Van Den Broek, Walter W., Van Saase, Jan L C M, Schmidt, Henk G., Leerstoel van Gog, Education and Learning: Development in Interaction |
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| Přispěvatelé: | Leerstoel van Gog, Education and Learning: Development in Interaction, Erasmus MC other, Department of Psychology, Education and Child Studies, Internal Medicine, General Practice |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Diagnostic errors
Medical education medicine.medical_specialty Pediatrics Recall business.industry 030503 health policy & services Health Policy Alternative medicine Diagnostic reasoning Diagnostic accuracy Affect (psychology) 03 medical and health sciences 0302 clinical medicine Vignette Physical therapy Medicine 030212 general & internal medicine 0305 other medical science business Decision making |
| Zdroj: | BMJ Quality & Safety, 26(1), 13-18. BMJ Publishing Group BMJ Quality and Safety, 26(1), 13. BMJ Publishing Group |
| ISSN: | 2044-5415 |
| Popis: | Background Patients who display disruptive behaviours in the clinical encounter (the so-called ‘difficult patients’) may negatively affect doctors’ diagnostic reasoning, thereby causing diagnostic errors. The present study aimed at investigating the mechanisms underlying the negative influence of difficult patients’ behaviours on doctors’ diagnostic performance. Methods A randomised experiment with 74 internal medicine residents. Doctors diagnosed eight written clinical vignettes that were exactly the same except for the patients’ behaviours (either difficult or neutral). Each participant diagnosed half of the vignettes in a difficult patient version and the other half in a neutral version in a counterbalanced design. After diagnosing each vignette, participants were asked to recall the patient's clinical findings and behaviours. Main measurements were: diagnostic accuracy scores; time spent on diagnosis, and amount of information recalled from patients’ clinical findings and behaviours. Results Mean diagnostic accuracy scores (range 0–1) were significantly lower for difficult than neutral patients’ vignettes (0.41 vs 0.51; p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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