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Why verifying diagnostic decisions with a checklist can help: insights from eye tracking

Making a diagnosis involves ratifying or verifying a proposed answer. Formalizing this verification process with checklists, which highlight key variables involved in the diagnostic decision, is often advocated. However, the mechanisms by which a checklist might allow clinicians to improve their ver...

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Autores principales: Sibbald, Matthew, de Bruin, Anique B. H., Yu, Eric, van Merrienboer, Jeroen J. G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4564443/
https://www.ncbi.nlm.nih.gov/pubmed/25672896
http://dx.doi.org/10.1007/s10459-015-9585-1
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author Sibbald, Matthew
de Bruin, Anique B. H.
Yu, Eric
van Merrienboer, Jeroen J. G.
author_facet Sibbald, Matthew
de Bruin, Anique B. H.
Yu, Eric
van Merrienboer, Jeroen J. G.
author_sort Sibbald, Matthew
collection PubMed
description Making a diagnosis involves ratifying or verifying a proposed answer. Formalizing this verification process with checklists, which highlight key variables involved in the diagnostic decision, is often advocated. However, the mechanisms by which a checklist might allow clinicians to improve their verification process have not been well studied. We hypothesize that using a checklist to verify diagnostic decisions enhances analytic scrutiny of key variables, thereby improving clinicians’ ability to find and fix mistakes. We asked 16 participants to verify their interpretation of 12 electrocardiograms, randomly assigning half to be verified with a checklist and half with an analytic prompt. While participants were verifying their interpretation, we tracked their eye movements. We analyzed these eye movements using a series of eye tracking variables theoretically linked to analytic scrutiny of key variables. We found that more errors were corrected using a checklist compared to an analytic prompt (.27 ± .53 errors per ECG vs. .04 ± .43, F (1,15) = 8.1, p = .01, η (2) = .20). Checklist use was associated with enhanced analytic scrutiny in all eye tracking measures assessed (F (6,10) = 6.0, p = .02). In this experiment, using a key variable checklist to verify diagnostic decisions improved error detection. This benefit was associated with enhanced analytic scrutiny of those key variables as measured by eye tracking.
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spelling pubmed-45644432015-09-15 Why verifying diagnostic decisions with a checklist can help: insights from eye tracking Sibbald, Matthew de Bruin, Anique B. H. Yu, Eric van Merrienboer, Jeroen J. G. Adv Health Sci Educ Theory Pract Article Making a diagnosis involves ratifying or verifying a proposed answer. Formalizing this verification process with checklists, which highlight key variables involved in the diagnostic decision, is often advocated. However, the mechanisms by which a checklist might allow clinicians to improve their verification process have not been well studied. We hypothesize that using a checklist to verify diagnostic decisions enhances analytic scrutiny of key variables, thereby improving clinicians’ ability to find and fix mistakes. We asked 16 participants to verify their interpretation of 12 electrocardiograms, randomly assigning half to be verified with a checklist and half with an analytic prompt. While participants were verifying their interpretation, we tracked their eye movements. We analyzed these eye movements using a series of eye tracking variables theoretically linked to analytic scrutiny of key variables. We found that more errors were corrected using a checklist compared to an analytic prompt (.27 ± .53 errors per ECG vs. .04 ± .43, F (1,15) = 8.1, p = .01, η (2) = .20). Checklist use was associated with enhanced analytic scrutiny in all eye tracking measures assessed (F (6,10) = 6.0, p = .02). In this experiment, using a key variable checklist to verify diagnostic decisions improved error detection. This benefit was associated with enhanced analytic scrutiny of those key variables as measured by eye tracking. Springer Netherlands 2015-02-12 2015 /pmc/articles/PMC4564443/ /pubmed/25672896 http://dx.doi.org/10.1007/s10459-015-9585-1 Text en © The Author(s) 2015 https://creativecommons.org/licenses/by/4.0/ Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Article
Sibbald, Matthew
de Bruin, Anique B. H.
Yu, Eric
van Merrienboer, Jeroen J. G.
Why verifying diagnostic decisions with a checklist can help: insights from eye tracking
title Why verifying diagnostic decisions with a checklist can help: insights from eye tracking
title_full Why verifying diagnostic decisions with a checklist can help: insights from eye tracking
title_fullStr Why verifying diagnostic decisions with a checklist can help: insights from eye tracking
title_full_unstemmed Why verifying diagnostic decisions with a checklist can help: insights from eye tracking
title_short Why verifying diagnostic decisions with a checklist can help: insights from eye tracking
title_sort why verifying diagnostic decisions with a checklist can help: insights from eye tracking
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4564443/
https://www.ncbi.nlm.nih.gov/pubmed/25672896
http://dx.doi.org/10.1007/s10459-015-9585-1
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