For Diagnostic Reasoning Accuracy, Experience Helps — Time Pressure & Interruptions Don’t Hurt

accuracy  Forty-six US and Canadian ER attending physicians and 152 multi-specialty Canadian residents sitting for Part II qualifying exams were given 20 general medical diagnostic cases.  Attendings scored more correct answers (71%) than residents (43%).  Test-takers were randomly exposed to different testing conditions – a “fast” vs. “slow” time condition, and an interruption vs. no-interruption condition.  During the “fast” condition, participants were told to “work as quickly as you can without sacrificing accuracy,” while during the “slow” condition, they were advised to “consider all the data before you arrive at your diagnosis,” and they were given 50% more time.  Half of the questions were non-interrupted, while the other half were interrupted by an audible 4-digit number which had to be transcribed at the end of the case and a visual unrelated multiple-choice question.  Interruptions and the “slow” condition increase the time for physicians to come to a response, but did not change the overall accuracy of the answers. — Laura Willett, MD

Monteiro SD, Sherbino JD, Ilgen JS, Dore KL, Wood TJ, Young ME, Bandiera G, Blouin D, Gaissmaier W, Norman GR, Howey E. Disrupting Diagnostic Reasoning: Do Interruptions, Instructions, and Experience Affect the Diagnostic Accuracy and Response Time of Residents and Emergency Physicians?
Acad Med. 2015 Jan

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