The Role of Information Visualisation and Anecdotal Evidence in Medical Students' Clinical Reasoning Process: A Cross-Sectional Survey Study.

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.