Examining the stability of experts’ clinical case processing: An experimental manipulation

Authors: De Bruin, Anique1; Van De Wiel, Margaretha2; Rikers, Remy3; Schmidt, Henk3

Source: Instructional Science, Volume 33, Number 3, May 2005 , pp. 251-270(20)

Publisher: Springer

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Abstract:

The present study was undertaken to examine the hypothesis that the intermediate effect in clinical case recall is partly explained by experts’ lower motivation to write down everything they remember when asked for free recall. Medical experts and students were presented with two clinical cases, which they had to read, diagnose, and recall. Participants received an instruction before processing the cases that aimed at minimizing motivation in one condition, and enhance motivation in another. A third condition received a standard instruction, comparable to previous clinical case representation studies. The results showed that medical experts’ clinical case processing mode is robust and insensitive to pressure induced by a social comparison instruction. In all conditions, recall data showed an intermediate effect, indicating encapsulated processing by the expert group. Moreover, there were no differences between the conditions in diagnostic accuracy, number of summaries in recall, and study time on the cases. Although experts showed that they were affected by the instruction, their processing mode remained stable over the three conditions. Expert physicians, even under conditions of considerable pressure, process clinical cases in an encapsulated mode.

Keywords: expert processing; knowledge encapsulation; knowledge representation; motivation; medicine

Document Type: Research article

DOI: 10.1007/s11251-005-3598-8

Affiliations: 1: Department of Psychology, WJ5–09, Erasmus University Rotterdam, P.O. Box 17383000, DR, Rotterdam, The Netherlands, Email: debruin@fsw.eur.nl 2: Maastricht University, The Netherlands, 3: Department of Psychology, WJ5–09, Erasmus University Rotterdam, P.O. Box 17383000, DR, Rotterdam, The Netherlands,

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