ArticleSingapore medical journal2016
Teaching metacognition in clinical decision-making using a novel mnemonic checklist: an exploratory study.
Article in Singapore medical journal, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- How and When Should Clinical Reasoning Be Taught in Undergraduate Medicine: A Systematic Review and Meta-Analyses.Perspectives on medical education · 2025Pooled it
- Effect on diagnostic accuracy of cognitive reasoning tools for the workplace setting: systematic review and meta-analysis.BMJ quality & safety · 2022Pooled it
- Checklists to reduce diagnostic error: a systematic review of the literature using a human factors framework.BMJ open · 2022Pooled it
- How Do Contexts Affect Physicians' Clinical Reasoning? A Narrative Review.MedEdPublish (2016) · 2020Pooled it
- A cognitive forcing tool to mitigate cognitive bias - a randomised control trial.BMC medical education · 2019Trial
- Cognitive bias in veterinary clinical decision-making: Antemortem misdiagnosis of suspected giant kidney worm (Dioctophyme renale) in Australia.Australian veterinary journal · 2026Article
- Enhancing Physician Resilience to Generative AI: Multilevel Framework for Shared Authority, Verification, and Skill Preservation.Journal of medical Internet research · 2026Article
- Article
- Physicians' metacognition in medical decision-making.Neuroscience of consciousness · 2026Article
- Teaching common cognitive biases and associated errors in veterinary neurologic diagnosis using clinical vignettes: a narrative review.Frontiers in veterinary science · 2026Review
- Enhancing therapeutic reasoning: key insights and recommendations for education in prescribing.BMC medical education · 2024Review
- Nurses' Anxiety Mediates the Relationship between Clinical Tolerance to Uncertainty and Antibiotic Initiation Decisions in Residential Aged-Care Facilities.Medical decision making : an international journal of the Society for Medical Decision Making · 2024Article
- Educational strategies in the health professions to mitigate cognitive and implicit bias impact on decision making: a scoping review.BMC medical education · 2023Article
- A scoping review of clinical reasoning research with Asian healthcare professionals.Advances in health sciences education : theory and practice · 2021Article
- The effect of peer mentoring on motivation and self-regulated learning in medical students during transition.Journal of education and health promotion · 2021Article
- Teaching heuristics and mnemonics to improve generation of differential diagnoses.Medical education online · 2020Article
- Review of the Basics of Cognitive Error in Emergency Medicine: Still No Easy Answers.The western journal of emergency medicine · 2020Review
- Perception of the usability and implementation of a metacognitive mnemonic to check cognitive errors in clinical setting.BMC medical education · 2019Article
- TBC: A simple algorithm to rule out abnormalities in electrocardiograms of patients with pacemakers.Cardiology journal · 2018Article
- Investing in the use of a checklist during differential diagnoses consideration: what's the trade-off?BMC medical education · 2017Article
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3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMetacognition is a cognitive debiasing strategy that clinicians can use to deliberately detach themselves from the immediate context of a clinical decision, which allows them to reflect upon the thinking process. However, cognitive debiasing strategies are often most needed when the clinician cannot afford the time to use them. A mnemonic checklist known as TWED (T = threat, W = what else, E = evidence and D = dispositional factors) was recently created to facilitate metacognition. This study explores the hypothesis that the TWED checklist improves the ability of medical students to make better clinical decisions.
methodsTwo groups of final-year medical students from Universiti Sains Malaysia, Malaysia, were recruited to participate in this quasi-experimental study. The intervention group (n = 21) received educational intervention that introduced the TWED checklist, while the control group (n = 19) received a tutorial on basic electrocardiography. Post-intervention, both groups received a similar assessment on clinical decision-making based on five case scenarios.
resultsThe mean score of the intervention group was significantly higher than that of the control group (18.50 ± 4.45 marks vs. 12.50 ± 2.84 marks, p < 0.001). In three of the five case scenarios, students in the intervention group obtained higher scores than those in the control group.
conclusionThe results of this study support the use of the TWED checklist to facilitate metacognition in clinical decision-making.
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