In simulated trauma cases, senior residents followed algorithms better, but did worse than juniors when was judgment required.Simul Healthc. 2015 Feb 23; [Epub ahead of print].
Decision making in trauma settings: simulation to improve diagnostic skills.
Murray DJ, Freeman BD, Boulet JR, Woodhouse J, Fehr JJ, Klingensmith ME. Simul Healthc. 2015 Feb 23; [Epub ahead of print].
Simulation training has been used to improve patient safety across multiple care settings. This study sought to enhance diagnostic accuracy for trauma care among resident-level trainees. Researchers developed several standardized cases to assess care for a patient presenting with severe injury. Some scenarios were algorithmic and others required more analysis. Residents with more years of training performed better on the simpler scenarios but worse on the analytic scenarios which required that they reassess their diagnosis. This finding suggests that those with more experience assimilated the algorithms more readily, but they also continue to need cognitive training for diagnostic accuracy. A past AHRQ WebM&M interview with Dr. Pat Croskerry discusses the need to enhance cognitive skills for diagnosis in medical training.
Disrupting diagnostic reasoning: do interruptions, instructions, and experience affect the diagnostic accuracy and response time of residents and emergency physicians?
Monteiro SD, Sherbino JD, Ilgen JS, et al. Acad Med. 2015 Jan 6; [Epub ahead of print].
The "July phenomenon": is trauma the exception?
Schroeppel TJ, Fischer PE, Magnotti LJ, Croce MA, Fabian TC. J Am Coll Surg. 2009;209:378-384.
The influence of the causes and contexts of medical errors on emergency medicine residents' responses to their errors: an exploration.
Hobgood C, Hevia A, Tamayo-Sarver JH, Weiner B, Riviello R. Acad Med. 2005;80:758-764.
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Stout D. New York Times. June 17, 2006;National desk:9.