The identification and classification of errors in medical diagnosis made by selected pediatric residents.
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| Other Authors: | , , |
| Format: | Thesis Book |
| Language: | English |
| Published: |
1984.
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| Subjects: | |
| Online Access: | Link to ProQuest Copy Link to OAKTrust copy |
| Abstract: | This study was designed to identify and classify errors in medical diagnosis made by selected pediatric resident physicians. Five experienced pediatric cardiologists and ten pediatric resident physicians were requested to think aloud during the diagnosis of two pediatric cardiology problems. A printed patient description was given to each physician, but other patient information was given only upon specific request. Verbal protocols were tape recorded and transcribed, then reduced to relevant statements. The diagnostically-related statements were classified into four stages of medical diagnosis: data collection, data interpretation, diagnosis generation and diagnosis evaluation. Three raters independently classified the experts' statements to determine objectivity with results indicating substantial agreement between raters. Experts' statements were used to develop standards of diagnosis. Errors were identified by determining the differences between the residents' statements and the standards. Errors were classified according to the stage of diagnosis in which they occurred, and then analyzed to determine which errors were most prevalent and the stage of diagnosis in which most errors occurred. Study conclusions are limited to the 10 subjects and the 2 patient problems. They are as follows. (1) Resident physicians make errors of omission more frequently than errors of commission. (2) Resident physicians make the most overall errors and the most errors of omission in Stage 4 (Diagnosis Evaluation). (3) Resident physicians omit plausible diagnoses in Stage 3 (Diagnosis Generation) which leads to most errors in Stage 4 and, consequently, to most errors in the diagnostic process. (4) Resident physicians generate more non-plausible diagnoses than plausible diagnoses. (5) Resident physicians interpret a small proportion of the patient data that they collect. (6) Resident physicians make the least errors and the least errors of omission in Stage 1 (Data Collection). Seven recommendations for further research were made. It was suggested that the method of identification and classification of errors be incorporated into computer programs for practice in medical problem solving. |
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| Item Description: | "Major subject: Health Education." Typescript (photocopy). Vita. |
| Physical Description: | xii, 165 leaves ; 29 cm |
| Bibliography: | Includes bibliographical references (leaves 122-128). |