Comparing Methods of Learning Clinical Prediction from Case Simulations
- 1 August 1992
- journal article
- case report
- Published by SAGE Publications in Medical Decision Making
- Vol. 12 (3), 213-221
- https://doi.org/10.1177/0272989x9201200307
Abstract
Feedback to physicians about how they use information in making judgments can improve the quality of their judgments, but questions remain about which types of feedback are most effective. The authors conducted a controlled study of feedback in 60 medical students learning to predict the risk of cardiovascular death based on the presence or absence of five risk factors. After a pretest of 40 cases abstracted from patient records, the students worked through 173 computer-simulated cases and a posttest of 40 patient cases. The students received no feedback, probability feedback (correct probability of cardiac death for each case), cognitive feedback (the correct cue weights compared with their own weights derived from the previous set of cases), or both types of feedback. Students who received probability feedback markedly improved both base rate calibration and discrimination. Those who received only cognitive feedback showed no improvement over control on any of the measures of learning. All subjects were highly consistent in their weightings. The superiority of probability feedback differed from previous findings that cognitive feedback was essential for mastery of multiple-cue-probability learning tasks. The information on cue-outcome relationships given by cognitive feedback may be more useful when these relationships are complex and the combining rule is not known, while the precise outcome information provided by probabilistic feedback is more useful when the combining rule is known and the cue- outcome relationships are straightforward. Thus, the optimal method of learning depends on the nature of the task. Key words: risk factors; computer simulations; heart disease. (Med Decis Making 1992;12:213-221)Keywords
This publication has 23 references indexed in Scilit:
- Teaching old dogs new tricksAcademic Medicine, 1990
- An Eualuation of Clinicians' Subjective Prior Probability EstimatesMedical Decision Making, 1986
- The accuracy of experienced physicians' probability estimates for patients with sore throats. Implications for decision makingPublished by American Medical Association (AMA) ,1985
- The influence of formal, substantive, and contextual task properties on the relative effectiveness of different forms of feedback in multiple-cue probability learning tasksOrganizational Behavior and Human Performance, 1981
- Multidimensional functional learning (MFL) and some new conceptions of feedbackOrganizational Behavior and Human Performance, 1981
- Feedback and task predictability as determinants of performance in multiple cue probability learning tasksOrganizational Behavior and Human Performance, 1976
- Linear models in decision making.Psychological Bulletin, 1974
- Negative effects of outcome-feedback in multiple-cue probability learningOrganizational Behavior and Human Performance, 1973
- Computer Graphics as an Aid to LearningScience, 1971
- Simple models or simple processes? Some research on clinical judgments.American Psychologist, 1968