RT Journal Article
SR Electronic
T1 Contextual information influences diagnosis accuracy and decision making in simulated emergency medicine emergencies
JF BMJ Quality & Safety
JO BMJ Qual Saf
FD BMJ Publishing Group Ltd
SP 478
OP 484
DO 10.1136/bmjqs-2012-000972
VO 22
IS 6
A1 McRobert, Allistair Paul
A1 Causer, Joe
A1 Vassiliadis, John
A1 Watterson, Leonie
A1 Kwan, James
A1 Williams, Mark A
YR 2013
UL http://qualitysafety.bmj.com/content/22/6/478.abstract
AB Background It is well documented that adaptations in cognitive processes with increasing skill levels support decision making in multiple domains. We examined skill-based differences in cognitive processes in emergency medicine physicians, and whether performance was significantly influenced by the removal of contextual information related to a patient's medical history. Method Skilled (n=9) and less skilled (n=9) emergency medicine physicians responded to high-fidelity simulated scenarios under high- and low-context information conditions. Results Skilled physicians demonstrated higher diagnostic accuracy irrespective of condition, and were less affected by the removal of context-specific information compared with less skilled physicians. The skilled physicians generated more options, and selected better quality options during diagnostic reasoning compared with less skilled counterparts. These cognitive processes were active irrespective of the level of context-specific information presented, although high-context information enhanced understanding of the patients’ symptoms resulting in higher diagnostic accuracy. Conclusions Our findings have implications for scenario design and the manipulation of contextual information during simulation training.