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Background: Diagnostic error is a major source of patient suffering. Researchshows that physicians experience frequent interruptions while being engaged with patients and indicate that diagnostic accuracy may be impaired as a result. Since most studies in the field are observational, there is as yet no evidence suggesting a direct causal link between being interrupted and diagnostic error. Theexperiments reported in this article were intended to assess this hypothesis.
Methods: Three experiments were conducted to test the hypothesis that interruptions hurt diagnostic reasoning and increase time on task. In the first experiment (N = 42), internal medicine residents, while diagnosing vignettes of actual clinical cases were interrupted halfway with a task unrelated to medicine, solving word-spotting puzzles and anagrams. In the second experiment (N = 78), the interruptions were medically relevant ones. In the third experiment (N = 30), we put additional time pressure on the participants. In all these experiments, a control group diagnosed the cases without interruption. Dependent variables were diagnostic accuracy and amount of time spent on the vignettes.
Results: In none of the experiments interruptions were demonstrated to influence diagnostic accuracy. In Experiment 1: Mean of interrupted group was 0.88 (SD = 0.37) versus non- interrupted group 0.91 (SD = 0.32). In Experiment 2: Mean of interrupted group was 0.95 (SD = 0.32) versus non-interrupted group 0.94 (SD = 0.38). In Experiment 3: Mean of interrupted group was 0.42 (SD = 0.12) versus non-interrupted group 0.37 (SD = 0.08). Although interrupted residents in all experiments needed more time to complete the diagnostic task, only in Experiment 2, this effect was statistically significant.
Conclusions: These three experiments, taken together, failed to demonstrate negative effects of interruptions on diagnostic reasoning. Perhaps physicians who are interrupted may still have sufficient cognitive resources available to recover from it most of the time.
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http://dx.doi.org/10.1186/s12909-022-03212-1 | DOI Listing |
J Ultrason
December 2024
Motion Analysis Laboratory, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.
Aim: There is a need to evaluate the tissue deformation index of lateral abdominal muscles using M-mode ultrasound in a cohort of healthy subjects to establish a convenient reference point for clinical reasoning in patients. The aim of the study was to assess differences in the tissue deformation index between individual lateral abdominal muscles regardless of body side, compare these differences in the tissue deformation index on the right and left sides of the body, and evaluate side-to-side differences in the tissue deformation index within individual lateral abdominal muscles.
Material And Methods: In a group of 126 healthy volunteers (59 females), the postural response of lateral abdominal muscles to external perturbation in the form of rapid arm abduction with load was recorded on both sides of the body, and the tissue deformation index was calculated.
Front Neurol
December 2024
Neuromuscular Imaging Research Lab, The Kolling Institute, North Sydney Local Health District, St Leonards, NSW, Australia.
Individuals with joint hypermobility and the Ehlers-Danlos Syndromes (EDS) are disproportionately affected by neuraxial dysfunction and Central Nervous System (CNS) disorders: such as Spontaneous Intracranial Hypotension (SIH) due to spinal cerebrospinal fluid (CSF) leaks, Upper Cervical Instability (UCI; including craniocervical or atlantoaxial instability (CCI/AAI)), Occult Tethered Cord Syndrome (TCS), Chiari Malformation (CM) and Idiopathic Intracranial Hypertension (IIH). The neuraxis comprises the parts of the nervous system (brain, nerves, spinal cord) along the craniospinal axis of the body. Neuraxial tissue includes all tissue structures that comprise, support, sheath, and connect along the neuraxis and peripheral nerves.
View Article and Find Full Text PDFFront Oncol
December 2024
Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Background: Prostate cancer is a common cancer among men globally and its treatment affects quality of life. Poor patients' perception of prostate cancer services may lead to their late presentation for care, often presenting with the advanced stage of the disease. This may vary from one region to another.
View Article and Find Full Text PDFBMC Med Educ
December 2024
Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, 600077, India.
Introduction: This scoping review aimed to review the various challenges facing dental education. Dental education faces multiple institutional, student and faculty-based challenges. Institutional challenges include updating infrastructure resources, recruiting qualified faculty, and implementing administrative policies that enhance dental education.
View Article and Find Full Text PDFBMC Anesthesiol
December 2024
Department of Anesthesiology, Ningbo No.2 Hospital, No.41, Northwest Street, Ningbo, 315010, P.R. China.
Background: Developing proficiency in ultrasound-guided nerve block (UGNB) demands an intricate understanding of cross-sectional anatomy as well as spatial reasoning, which is a big challenge for beginners. The aim of this pilot study was to evaluate the feasibility of virtual reality (VR)-facilitated anatomy education in the first performance of ultrasound-guided interscalene brachial plexus blockade among novice anesthesiologists. We carried out pilot testing of this hypothesis using a prospective, single blind, randomized controlled trial.
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