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Blink or think: can further reflection improve initial diagnostic impressions?
Acad Med
January 2015
Dr. Hess is a consultant, Hess Consulting, St-Nicolas, Québec, Canada. Dr. Lipner is senior vice president of evaluation, research and development, American Board of Internal Medicine, Philadelphia, Pennsylvania. Dr. Thompson is professor of cognitive psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Dr. Holmboe is senior vice president of milestone development and evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois. Dr. Graber is senior research fellow, RTI International, Research Triangle Park, North Carolina, and professor emeritus, at SUNY Stony Brook University School of Medicine, Stony Brook, New York.
Purpose: Experienced clinicians derive many diagnoses intuitively, because most new problems they see closely resemble problems they've seen before. The majority of these diagnoses, but not all, will be correct. This study determined whether further reflection regarding initial diagnoses improves diagnostic accuracy during a high-stakes board exam, a model for studying clinical decision making.
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