Journal article
Diagnostic Reasoning by Expert Clinicians: What Distinguishes Them From Their Peers?
Curēus (Palo Alto, CA), Vol.13(11), pp.e19722-e19722
11/18/2021
DOI: 10.7759/cureus.19722
PMCID: PMC8684366
PMID: 34934585
Abstract
Objectives
Expert clinicians (ECs) are defined in large part as a group of physicians recognized by their peers for their diagnostic reasoning abilities. However, their reasoning skills have not been quantitatively compared to other clinicians using a validated instrument.
Methods
We surveyed Internal Medicine physicians at the University of Iowa to identify ECs. These clinicians were administered the Diagnostic Thinking Inventory, along with an equivalent number of their peers in the general population of internists. Scores were tabulated for structure and thinking, as well as four previously identified elements of diagnostic reasoning (data acquisition, problem representation, hypothesis generation, and illness script search and selection). We compared scores between the two groups using the two-sample t-test.
Results
Seventeen ECs completed the inventory (100%). Out of 25 randomly-selected non-EC internists (IM), 19 completed the inventory (76%). Mean total scores were 187.2 and 175.8 for the EC and the IM groups respectively. Thinking and structure subscores were 91.5 and 95.71 for ECs, compared to 85.5 and 90.3 for IMs (p-values: 0.0783 and 0.1199, respectively). The mean data acquisition, problem representation, hypothesis generation, and illness script selection subscores for ECs were 4.46, 4.57, 4.71, and 4.46, compared to 4.13, 4.38, 4.45, and 4.13 in the IM group (p-values: 0.2077, 0.4528, 0.095, and 0.029, respectively).
Conclusions
ECs have greater proficiency in searching for and selecting illness scripts compared to their peers. There were no statistically significant differences between the other scores and subscores. These results will help to inform continuing medical education efforts to improve diagnostic reasoning.
Details
- Title: Subtitle
- Diagnostic Reasoning by Expert Clinicians: What Distinguishes Them From Their Peers?
- Creators
- Bharat Kumar - University of Iowa Hospitals and ClinicsKristi Ferguson - University of IowaMelissa Swee - University of IowaManish Suneja - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Curēus (Palo Alto, CA), Vol.13(11), pp.e19722-e19722
- Publisher
- Cureus Inc
- DOI
- 10.7759/cureus.19722
- PMID
- 34934585
- PMCID
- PMC8684366
- ISSN
- 2168-8184
- eISSN
- 2168-8184
- Number of pages
- 9
- Language
- English
- Date published
- 11/18/2021
- Academic Unit
- Nephrology; Immunology; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984362670202771
Metrics
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