Mutlak Zeinab, Saqer Noor, Chan See Chai Carol, Majeed Azeem, Jerjes Waseem
Brighton and Sussex Medical School, University of Sussex, Brighton BN1 9PX, UK.
Faculty of Medicine, Imperial College London, 86 Wood Lane, London W12 0BZ, UK.
J Clin Med. 2025 Jun 11;14(12):4139. doi: 10.3390/jcm14124139.
Diagnostic accuracy is essential for good-quality medical practice, and yet diagnostic errors remain widespread, influencing patient outcomes, healthcare costs, and clinician confidence. "Misdiagnosis Tracker" aims to instil error analysis into medical education and shift the focus toward the learning of lessons from errors in diagnosis. This study investigates how systematic review of diagnostic errors enhances medical students' competence in diagnostic reasoning, identification of cognitive bias, and identification of atypical presentations. A cohort of 65 final-year medical students participated in a structured three-phase educational intervention comprising preparation, case study analysis, and reflection. Students examined 20 diagnostic error case studies to identify contributory factors, such as cognitive biases, atypical presentations, and systemic barriers. Quantitative data were obtained from pre- and post-study surveys assessing confidence and knowledge, while qualitative insights were gathered through group reports, reflective journals, and debriefing sessions. The results indicated significant improvements in confidence in diagnostic reasoning (3.0 to 4.4, < 0.01), awareness of cognitive bias (2.9 to 4.5, < 0.01), and recognition of atypical presentations (3.1 to 4.6, < 0.01). Qualitative results highlighted increased insight into red flags, systemic issues, and reflective development. Actionable recommendations made by the students were systematic diagnostic frameworks, better interprofessional communication, and focused education on cognitive bias. This study illustrates how the "Misdiagnosis Tracker" greatly enhances medical students' reflective and diagnostic reasoning skills and better prepares them for clinical practice. By fostering an environment of learning from diagnostic mistakes, this approach could ultimately result in fewer diagnostic errors and improved patient outcomes. Longitudinal studies are essential to determine the long-term effect of this model on clinical competence and its application in different education settings.
诊断准确性对于高质量的医疗实践至关重要，但诊断错误仍然普遍存在，影响着患者的治疗结果、医疗成本和临床医生的信心。“误诊追踪器”旨在将错误分析融入医学教育，并将重点转向从诊断错误中吸取教训。本研究调查了对诊断错误的系统回顾如何提高医学生的诊断推理能力、认知偏差识别能力和非典型表现识别能力。一组65名医学专业最后一年的学生参与了一项结构化的三阶段教育干预，包括准备、案例分析和反思。学生们研究了20个诊断错误案例，以确定促成因素，如认知偏差、非典型表现和系统障碍。通过研究前和研究后的调查获取评估信心和知识的定量数据，同时通过小组报告、反思日志和汇报会收集定性见解。结果表明，在诊断推理信心（从3.0提高到4.4，<0.01）、认知偏差意识（从2.9提高到4.5，<0.01）和非典型表现识别（从3.1提高到4.6，<0.01）方面有显著提高。定性结果突出了对警示信号、系统问题和反思发展的深入洞察。学生们提出的可行建议包括系统的诊断框架、更好的跨专业沟通以及针对认知偏差的重点教育。本研究说明了“误诊追踪器”如何极大地提高医学生的反思和诊断推理能力，并使他们更好地为临床实践做好准备。通过营造一个从诊断错误中学习的环境，这种方法最终可能会减少诊断错误并改善患者治疗结果。纵向研究对于确定该模式对临床能力的长期影响及其在不同教育环境中的应用至关重要。
