Eberhard J, Klomp H-J, Föge M, Hedderich J, Schmidt H G
Department of Operative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Carl-Neuberg-Strasse 1, Hannover, Germany.
Eur J Dent Educ. 2009 Aug;13(3):128-34. doi: 10.1111/j.1600-0579.2008.00550.x.
The extensive knowledge of experts facilitates the solving of domain-specific problems. In general, this is due to the fact that experts recall more detailed information than do novices or even advanced students. However, if physicians of different expertise levels are asked to write down the details of a given case, advanced medical students recall more information than experts. This phenomenon was called the 'intermediate effect' and is considered to be a specific feature of medical expertise. The aim of the here presented study was to examine this observation in the domain of dental medicine.
Sixty-one students and 20 specialised dentists participated in this study. Three clinical case descriptions were presented and afterwards the participants were told to write down all concrete information they remembered. Finally, they had to come up with a diagnosis. Interrater agreement, diagnostic accuracy and the recall explanation protocols were analysed statistically in comparison to state-of-the-art (canonical) explanations of the clinical cases.
The mean interrater agreement was 96.2 +/- 3.37%. It was shown statistically that the more experienced the participants, the more accurate their diagnoses were (P < 0.001). The statistical analysis using the Games-Howell test demonstrated significant more written recall of the 5th-year students compared with 3rd- and 4th-year students and experts (P < 0.05).
The results of this study suggest the existence of the intermediate effect in clinical case recall in dental medicine and thereby corroborate its importance and general applicability for different medical domains.
专家的广博知识有助于解决特定领域的问题。一般来说，这是因为专家比新手甚至高年级学生能回忆起更详细的信息。然而，如果要求不同专业水平的医生写下给定病例的细节，高年级医学生回忆起的信息比专家更多。这种现象被称为“中间效应”，被认为是医学专业知识的一个特有特征。本研究的目的是在牙科医学领域检验这一观察结果。
61名学生和20名专科牙医参与了本研究。呈现了三个临床病例描述，之后要求参与者写下他们记住的所有具体信息。最后，他们必须得出诊断结果。与临床病例的最新（规范）解释相比，对评分者间一致性、诊断准确性和回忆解释方案进行了统计分析。
评分者间平均一致性为96.2 +/- 3.37%。统计学表明，参与者经验越丰富，其诊断越准确（P < 0.001）。使用Games-Howell检验的统计分析表明，与三年级、四年级学生和专家相比，五年级学生书面回忆的内容显著更多（P < 0.05）。
本研究结果表明牙科医学临床病例回忆中存在中间效应，从而证实了其在不同医学领域的重要性和普遍适用性。
