How Malpractice and Error Cases Influence Information Recall in General Practice Residents, a Vignette Study.

IF 4.8 2区医学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Perspectives on Medical Education Pub Date : 2025-04-29 eCollection Date: 2025-01-01 DOI:10.5334/pme.1730

Charlotte van Sassen, Walter van den Broek, Patrick Bindels, Laura Zwaan

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引用次数: 0

Abstract

Purpose: Integrating diagnostic error and malpractice cases into clinical reasoning education may enhance diagnostic reasoning by highlighting atypical presentations and diagnostic risks in complex contexts. While emotionally engaging, these cases might also affect information retention. This study examines how malpractice, error, and neutral case presentations influence recall for different information types and their interaction with learners' interest, satisfaction and anxiety levels.

Methods: In this two-phase between-subjects experiment, 89 first-year general practice (GP) residents reviewed four clinical vignettes in either malpractice, diagnostic error, or neutral formats. Vignettes were structurally identical, with claim-related details in malpractice versions replaced by general medical information in others. Anxiety was measured pre- and post-exercise. After a one-hour filler task, participants completed a free recall task, and their interest and satisfaction levels were assessed. Recalled idea units (clinical case-specific, medical-theoretical, claim-specific) were analyzed using ANOVAs.

Results: Anxiety, interest, and satisfaction levels remained similar across conditions. The proportion of total recalled idea units did not differ significantly (malpractice 11.38%, neutral 12.91%, error 13.12% p = 0.57). However, malpractice participants recalled fewer clinical case-specific units (malpractice 12.19%, neutral 19.43%, error 15.87% p = 0.007) while recalling more claim-specific units compared to medical-theoretical units in the other conditions (malpractice 7.23%, neutral 0.42%, error 1.3% p < 0.001).

Conclusion: GP residents retained fewer clinical case-specific details from malpractice claim vignettes than from neutral vignettes, with the missing information substituted by claim-specific details, without an increase in anxiety or interest. Further research is needed to understand the long-term impact of these differences on future diagnostic accuracy in clinical practice.

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医疗事故和错误案例如何影响全科医生的信息回忆，一个小插曲研究。

目的：将诊断错误和医疗事故案例整合到临床推理教育中，可以通过强调复杂情况下的非典型表现和诊断风险来提高诊断推理能力。虽然情感上很吸引人，但这些案例也可能影响信息保留。本研究探讨不当案例、错误案例和中性案例陈述如何影响不同信息类型的回忆，以及它们与学习者兴趣、满意度和焦虑水平的相互作用。方法：在这个两阶段的受试者间实验中，89名一年级全科医生（GP）住院医生回顾了4个临床小插曲，包括医疗事故、诊断错误或中性格式。小插曲在结构上是相同的，医疗事故版本中与索赔相关的细节被其他版本中的一般医疗信息所取代。在运动前和运动后测量焦虑。在一个小时的填充物任务后，参与者完成了一个自由回忆任务，并评估了他们的兴趣和满意度。回忆的想法单元（临床病例特异性、医学理论特异性、索赔特异性）采用方差分析进行分析。结果：焦虑、兴趣和满意度在不同条件下保持相似。总回忆概念单元的比例差异无统计学意义（不良11.38%，中性12.91%，误差13.12% p = 0.57）。然而，与其他条件下的医学理论单位相比，医疗事故参与者回忆的临床病例特异性单位较少（医疗事故12.19%，中性19.43%，误差15.87% p = 0.007），而回忆的索赔特异性单位较多（医疗事故7.23%，中性0.42%，误差1.3% p < 0.001）。结论：全科医生从医疗事故索赔小片段中保留的临床病例特异性细节比从中性小片段中保留的少，缺失的信息被索赔特异性细节所取代，没有增加焦虑或兴趣。需要进一步的研究来了解这些差异对临床实践中未来诊断准确性的长期影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Perspectives on Medical Education Multiple-

CiteScore

5.70

自引率

8.30%

发文量

审稿时长

28 weeks

期刊介绍： Perspectives on Medical Education mission is support and enrich collaborative scholarship between education researchers and clinical educators, and to advance new knowledge regarding clinical education practices. Official journal of the The Netherlands Association of Medical Education (NVMO). Perspectives on Medical Education is a non-profit Open Access journal with no charges for authors to submit or publish an article, and the full text of all articles is freely available immediately upon publication, thanks to the sponsorship of The Netherlands Association for Medical Education. Perspectives on Medical Education is highly visible thanks to its unrestricted online access policy. Perspectives on Medical Education positions itself at the dynamic intersection of educational research and clinical education. While other journals in the health professional education domain orient predominantly to education researchers or to clinical educators, Perspectives positions itself at the collaborative interface between these perspectives. This unique positioning reflects the journal’s mission to support and enrich collaborative scholarship between education researchers and clinical educators, and to advance new knowledge regarding clinical education practices. Reflecting this mission, the journal both welcomes original research papers arising from scholarly collaborations among clinicians, teachers and researchers and papers providing resources to develop the community’s ability to conduct such collaborative research. The journal’s audience includes researchers and practitioners: researchers who wish to explore challenging questions of health professions education and clinical teachers who wish to both advance their practice and envision for themselves a collaborative role in scholarly educational innovation. This audience of researchers, clinicians and educators is both international and interdisciplinary. The journal has a long history. In 1982, the journal was founded by the Dutch Association for Medical Education, as a Dutch language journal (Netherlands Journal of Medical Education). As a Dutch journal it fuelled educational research and innovation in the Netherlands. It is one of the factors for the Dutch success in medical education. In 2012, it widened its scope, transforming into an international English language journal. The journal swiftly became international in all aspects: the readers, authors, reviewers and editorial board members. The editorial board members represent the different parental disciplines in the field of medical education, e.g. clinicians, social scientists, biomedical scientists, statisticians and linguists. Several of them are leading scholars. Three of the editors are in the top ten of most cited authors in the medical education field. Two editors were awarded the Karolinska Institute Prize for Research. Presently, Erik Driessen leads the journal as Editor in Chief. Perspectives on Medical Education is highly visible thanks to its unrestricted online access policy. It is sponsored by theThe Netherlands Association of Medical Education and offers free manuscript submission. Perspectives on Medical Education positions itself at the dynamic intersection of educational research and clinical education. While other journals in the health professional education domain orient predominantly to education researchers or to clinical educators, Perspectives positions itself at the collaborative interface between these perspectives. This unique positioning reflects the journal’s mission to support and enrich collaborative scholarship between education researchers and clinical educators, and to advance new knowledge regarding clinical education practices. Reflecting this mission, the journal both welcomes original research papers arising from scholarly collaborations among clinicians, teachers and researchers and papers providing resources to develop the community’s ability to conduct such collaborative research. The journal’s audience includes researchers and practitioners: researchers who wish to explore challenging questions of health professions education and clinical teachers who wish to both advance their practice and envision for themselves a collaborative role in scholarly educational innovation. This audience of researchers, clinicians and educators is both international and interdisciplinary. The journal has a long history. In 1982, the journal was founded by the Dutch Association for Medical Education, as a Dutch language journal (Netherlands Journal of Medical Education). As a Dutch journal it fuelled educational research and innovation in the Netherlands. It is one of the factors for the Dutch success in medical education. In 2012, it widened its scope, transforming into an international English language journal. The journal swiftly became international in all aspects: the readers, authors, reviewers and editorial board members. The editorial board members represent the different parental disciplines in the field of medical education, e.g. clinicians, social scientists, biomedical scientists, statisticians and linguists. Several of them are leading scholars. Three of the editors are in the top ten of most cited authors in the medical education field. Two editors were awarded the Karolinska Institute Prize for Research. Presently, Erik Driessen leads the journal as Editor in Chief. Perspectives on Medical Education is highly visible thanks to its unrestricted online access policy. It is sponsored by theThe Netherlands Association of Medical Education and offers free manuscript submission.