Objective: Dealing with uncertainty is a core competence for physicians. To evaluate the impact of an educational intervention on family medicine residents' (FMRs') intention to request diagnostic tests and their attitudes toward uncertainty.
Methods: Nonrandomized controlled trial. Intervention group (IG) FMRs participated in interactive "dealing with uncertainty" seminars comprising statistical lessons and diagnostic reasoning. Control group (CG) FMRs participated in seminars without in-depth diagnostic lessons. FMRs completed the Dealing with Uncertainty Questionnaire (DUQ), comprising the Diagnostic Action and Diagnostic Reasoning scales. The Physicians' Reaction to Uncertainty (PRU) questionnaire, comprising 4 scales (Anxiety Due to Uncertainty, Concern about Bad Outcomes, Reluctance to Disclose Uncertainty to Patients, and Reluctance to Disclose Mistakes to Physicians) was also completed. Follow-up was performed 3 months later. Differences were calculated with repeated-measures analysis of variance.
Results: In total, 107 FMRs of the IG and 102 FMRs of the CG participated at baseline and follow-up. The mean (SD) Diagnostic Action scale score decreased from 24.0 (4.8) to 22.9 (5.1) in the IG and increased in the CG from 23.7 (5.4) to 24.1 (5.4), showing significant group difference ( = 0.006). The Diagnostic Reasoning scale increased significantly ( = 0.025) without a significant group difference ( = 0.616), from 19.2 (2.6) to 19.7 (2.4) in the IG and from 18.1 (3.3) to 18.8 (3.2) in the CG. The PRU scale Anxiety Due to Uncertainty decreased significantly ( = 0.029) without a significant group difference ( = 0.116), from 20.5 (4.8) to 18.5 (5.5) in the IG and from 19.9 (5.5) to 19.0 (6.0) in the CG.
Conclusion: The structured seminar reduced self-rated diagnostic test requisition. The change in Anxiety Due to Uncertainty and Diagnostic Reasoning might be due to an unspecific accompanying effect of the extra-occupational seminars for residents.
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http://dx.doi.org/10.1177/0272989X21989692 | DOI Listing |
Ann Intern Med
January 2025
Tufts University School of Medicine, Wellesley, Massachusetts (J.P.K.).
Discov Med (Cham)
December 2024
Department of Engineering in the Faculty of Science, Thompson Rivers University, 805 TRU Way, Kamloops, BC V2C 0C8 Canada.
Cardiovascular diseases are a major cause of mortality and morbidity. Fast detection of life-threatening emergency events and an earlier start of the therapy would save many lives and reduce successive disabilities. Understanding the specific risk factors associated with heart attack and the degree of association is crucial in the clinical diagnosis.
View Article and Find Full Text PDFWest J Nurs Res
January 2025
Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
Background: Nursing care plans document the nursing process, displaying actions, and illustrating expected outcomes. Their integration into electronic health records (EHRs) is critical for accurate documentation, enhanced by standardized nursing terminologies that promote communication, critical reasoning, and patient safety through consistent language for information.
Objective: This study aimed to identify appropriate standardized nursing terminology tailored to the context of a Northern Italian Cancer Center and research facility for developing nursing care plans and starting their integration into institutional EHRs.
Diagnosis (Berl)
January 2025
MedStar Washington Hospital Center, Washington, DC, USA.
Objectives: Published clinical reasoning curricula are limited, and measuring curricular impact has proven difficult. This study aims to evaluate the impact of a broad-reaching, multi-level reasoning curricula by measuring utilization of clinical reasoning terminology in published abstracts.
Methods: In 2014, the University of Pittsburgh Medical Center (UPMC) created a clinical reasoning curriculum with interventions at the student, resident, and faculty levels with the goal of bringing reasoning education to the forefront.
BMC Med Educ
January 2025
Department of Neurology, the First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, 518000, China.
In the modern medical education system, teaching of clinical neurology in outpatient settings is crucial for training future neurologists. The neurology outpatient clinic is a pivotal setting for both initial consultations and follow-up visits. It plays a significant role in the prevention, diagnosis, treatment, and ongoing monitoring of neurological disorders, and is a critical platform for clinical education.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!