Inducing System-1-type diagnostic reasoning in second-year medical students within 15 minutes

• Main Authors: Rosby, Lucy Victoria, Rotgans, Jerome Ingmar, Tan, Gerald, Low-Beer, Naomi, Mamede, Silvia, Zwaan, Laura, Schmidt, Henk
• Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
• Format: Article
• Language: English
• Published: 2020
• Subjects: Science::Medicine; Medical Students; Diagnostic Reasoning
• Online Access: https://hdl.handle.net/10356/140943
• Institution: Nanyang Technological University

Purpose: Diagnostic reasoning literature debates the significance of“dual-process theory”and the importance of its con- stituent types of thinking: System-1and System-2. This experimental study aimed to determine whether novice medical stu- dents could be trained to utilize System-1 thinking when making diagnoses based on chest X-rays. Method: Second-year medical students were recruited and presented with a series of eight online chest X-rays cases. Participants were shown half of the cases repeatedly during a training phase and the other half only twice. During the final test phase, they were shown all eight cases, providing a diagnosis as a free text answer. Dependent variables were diagnos- tic accuracy and response time. Results: Thirty-two students participated. During the test phase, students responses were significantly more accurate and faster for cases which had been seen repeatedly during the training phase (mean score¼3.56/4, mean time¼2.34 s) com- pared with cases which had been seen only twice (mean score¼1.59/4, mean time¼7.50 s). Conclusion: This study demonstrates that it is possible to induce in novice students the speed-to-diagnosis and diagnostic accuracy typical of System-1-type reasoning. The full experimental design and the chest X-rays used may provide new opportunities to explore some of the issues surrounding dual-process theory.