The Visualization of Uncertainty in Clinical Diagnostic Reasoning for Pulmonary Embolism

University of Calgary30 enrolled

Overview

Medical reasoning is a form of inquiry that examines the thought processes involved in making medical decisions. When physicians are faced with patients' symptoms or signs, their thought processes follow either direct shortcuts to suspect a diagnosis or go into a deeper and more analytic process to reach a diagnosis. The second pathway is less prone to biases and errors. This study explores whether the use of an interactive visual display of probabilities of pulmonary embolism generated from positive or negative test results will increase the adherence to evidence based guidelines in the diagnosis of pulmonary embolism.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Masking

NONE

Enrollment

Conditions

Pulmonary Embolism Diagnostic Uncertainty Clinical Reasoning Evidence Based Medicine Visualization of Uncertainty

Interventions

Visualized pulmonary embolism computer task modelOTHER

This group of participants was presented and trained to use a visual representation of diagnostic pathway for pulmonary embolism. The design of this visual representation is based on Bayes theorem and cognition enhancing visual design principles.

Didactic review lectureOTHER

This group of participants was presented with a didactic lecture covering the diagnostic approach of pulmonary embolism.

Eligibility

Sex: ALLMin age: 24 YearsMax age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Medical students, University of Calgary, in clerkship who finished at least 4 weeks of a block of medicine rotation at any hospital site. * First year subspecialty or Internal Medicine residents. * Practicing physicians in the subspecialties of Internal Medicine or Emergency Medicine. Exclusion Criteria: * Physicians in the subspecialty of Haematology or Respiratory

Outcomes

Primary Outcomes

Concordance with medical diagnostic reasoning pathway for pulmonary embolism.

Concordance with medical diagnostic reasoning pathway for a case presentation suggestive of pulmonary embolism will be reflected by whether participants are stopping prematurely or proceeding with diagnostic steps inappropriately.

Time frame: Paper-based clinical case scenarios were completed within 2 hour after either intervention.

Secondary Outcomes

Time.

The overall time taken to solve each clinical scenario may give insight to which decision making process was predominant to solve each clinical scenario.