Janssen Anna, Goldwater Micah B, Hilton Courtney B, Bonner Carissa, Shaw Tim
Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
School of Psychology, The University of Sydney, Sydney, NSW, Australia.
J Med Educ Curric Dev. 2024 Nov 21;11:23821205241293491. doi: 10.1177/23821205241293491. eCollection 2024 Jan-Dec.
Medical students are often taught clinical reasoning implicitly, rather than through a formal curriculum. Like qualified health professionals, they engage in a wide range of information seeking and other practices as part of the clinical reasoning process. This increasingly includes seeking out information online and being informed by anecdotal information from social media or peer groups. The aim of this research was to investigate how anecdotes and icon arrays influenced the clinical reasoning process of medical students deciding to prescribe a hypothetical new drug.
A cross-sectional survey design was used. The survey required participants to respond to six hypothetical clinical scenarios in which they were asked to prescribe a hypothetical drug "polypill" for a specific patient. The order of delivery of the six scenarios was randomised for each participant. In response to each scenario, participants indicated how effective they perceived each drug to be. The study received ethics approval from the University of Sydney Human Research Ethics Committee: Protocol No: 2019/001. All participants provided written informed consent before agreeing to participate in the study.
A total of 56 medical students fully completed the survey. Statistical analysis of the responses indicated that the icon array may be effective for highlighting how the polypill reduces CVD risk, reducing the impact of anecdotes on efficacy judgments. Without the icon array, both the positive and negative anecdotes made participants less willing to prescribe the polypill.
Medical student clinical reasoning processes appear to be influenced by anecdotal information and data visualisations. The extent of this influence is unclear, but there may be a need to actively educate students about the influence of these factors on their decision-making as they graduate into a world where they will be increasingly interacting with anecdotal information on social media and visualisations of electronic data.
医学生通常是通过隐性方式而非正式课程来学习临床推理。与合格的医疗专业人员一样，他们在临床推理过程中会进行广泛的信息搜索和其他活动。这越来越多地包括在网上查找信息，并受到社交媒体或同龄人群体的轶事信息的影响。本研究的目的是调查轶事和图标阵列如何影响医学生决定开具一种假设的新药的临床推理过程。
采用横断面调查设计。该调查要求参与者对六个假设的临床场景做出回应，在这些场景中，他们被要求为特定患者开具一种假设的药物“复方药丸”。六个场景的呈现顺序对每个参与者都是随机的。针对每个场景，参与者指出他们认为每种药物的效果如何。该研究获得了悉尼大学人类研究伦理委员会的伦理批准：方案编号：2019/001。所有参与者在同意参与研究之前均提供了书面知情同意书。
共有56名医学生完全完成了调查。对回复的统计分析表明，图标阵列可能有助于突出复方药丸如何降低心血管疾病风险，减少轶事对疗效判断的影响。没有图标阵列时，正面和负面轶事都会使参与者更不愿意开具复方药丸。
医学生的临床推理过程似乎受到轶事信息和数据可视化的影响。这种影响的程度尚不清楚，但随着学生毕业进入一个他们将越来越多地与社交媒体上的轶事信息和电子数据可视化进行互动的世界，可能需要积极教育他们这些因素对其决策的影响。
