TY - JOUR
T1 - Evidence of the preferential use of disease prototypes over case exemplars among early year one medical students prior to and following diagnostic training
AU - Papa, Frank J.
AU - Li, Feiming
N1 - Publisher Copyright:
© 2015, Frank J. Papa et al., published by De Gruyter 2015.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Background: Two core dual processing theory (DPT) System I constructs (Exemplars and Prototypes) were used to: 1) formulate a training exercise designed to improve diagnostic performance in year one medical students, and 2) explore whether any observed performance improvements were associated with preferential use of exemplars or prototypes. Methods: With IRB approval, 117 year one medical students participated in an acute chest pain diagnostic training exercise. A pre- and post-training test containing the same 27 case vignettes was used to determine if the subjects' diagnostic performance improved via training in both exemplars and prototypes. Exemplar and Prototype theory was also used to generate a unique typicality estimate for each case vignette. Because these estimates produce different performance predictions, differences in the subjects' observed performance would make it possible to infer whether subjects were preferentially using Exemplars or Prototypes. Results: Pre- vs. post-training comparison revealed a significant performance improvement; t=14.04, p<0.001, Cohen's d=1.32. Pre-training, paired t-testing demonstrated that performance against the most typical vignettes>mid typical vignettes: t=4.94, p<0.001; and mid typical>least typical: t=5.16, p<0.001. Post-training, paired t-testing again demonstrated that performance against the most typical vignettes>mid typical: t=2.94, p<0.01; and mid typical>least typical: t=6.64, p<0.001. These findings are more consistent with the performance predictions generated via Prototype theory than Exemplar theory. Conclusions: DPT is useful in designing and evaluating the utility of new approaches to diagnostic training, and, investigating the cognitive factors driving diagnostic capabilities among early medical students.
AB - Background: Two core dual processing theory (DPT) System I constructs (Exemplars and Prototypes) were used to: 1) formulate a training exercise designed to improve diagnostic performance in year one medical students, and 2) explore whether any observed performance improvements were associated with preferential use of exemplars or prototypes. Methods: With IRB approval, 117 year one medical students participated in an acute chest pain diagnostic training exercise. A pre- and post-training test containing the same 27 case vignettes was used to determine if the subjects' diagnostic performance improved via training in both exemplars and prototypes. Exemplar and Prototype theory was also used to generate a unique typicality estimate for each case vignette. Because these estimates produce different performance predictions, differences in the subjects' observed performance would make it possible to infer whether subjects were preferentially using Exemplars or Prototypes. Results: Pre- vs. post-training comparison revealed a significant performance improvement; t=14.04, p<0.001, Cohen's d=1.32. Pre-training, paired t-testing demonstrated that performance against the most typical vignettes>mid typical vignettes: t=4.94, p<0.001; and mid typical>least typical: t=5.16, p<0.001. Post-training, paired t-testing again demonstrated that performance against the most typical vignettes>mid typical: t=2.94, p<0.01; and mid typical>least typical: t=6.64, p<0.001. These findings are more consistent with the performance predictions generated via Prototype theory than Exemplar theory. Conclusions: DPT is useful in designing and evaluating the utility of new approaches to diagnostic training, and, investigating the cognitive factors driving diagnostic capabilities among early medical students.
KW - Dual Processing Theory
KW - Exemplar Theory
KW - Prototype Theory
UR - http://www.scopus.com/inward/record.url?scp=84994169695&partnerID=8YFLogxK
U2 - 10.1515/dx-2015-0024
DO - 10.1515/dx-2015-0024
M3 - Article
AN - SCOPUS:84994169695
SN - 2194-802X
VL - 2
SP - 217
EP - 225
JO - Diagnosis (Berlin, Germany)
JF - Diagnosis (Berlin, Germany)
IS - 4
ER -