Evidence map›Paper›PMID 32656357›Full record

ArticleJournal of medical education and curricular development

Medical Decision-Making in the Physician Hierarchy: A Pilot Pedagogical Evaluation.

John Rosasco, Michele L McCarroll, M David Gothard, Jerry Myers, Patrick Hughes, Alan Schwartz, Richard L George, Rami A Ahmed

Open access · goldAbstract read
In one paragraph

Article in Journal of medical education and curricular development. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.2field-weighted citation impact, top 42% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 7 institutions in 1 country.

John RosascoCollege of Osteopathic Medicine, Pacific Northwest University of Health Sciences, Yakima, WA, USA.
Michele L McCarrollCollege of Osteopathic Medicine, Pacific Northwest University of Health Sciences, Yakima, WA, USA.ORCID https://orcid.org/0000-0003-0950-8882
M David GothardBiostats, Inc., East Canton, OH, USA.
Jerry MyersHRP Cross Cutting Computational Modeling Project, NASA John H. Glenn Research Center, Cleveland, OH, USA.
Patrick HughesDepartment of Emergency Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA.
Alan SchwartzDepartment of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
Richard L GeorgeDepartment of Surgery, Trauma Program, Summa Health System -Akron Campus, Akron, OH, USA.
Rami A AhmedDepartment of Emergency Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA.
Pacific Northwest University of Health Sciences · USBiostats (United States) · USFlorida Atlantic University · USGlenn Research Center · USIndiana University Indianapolis · USSumma Health System · USUniversity of Illinois Chicago · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRecently, the American College of Graduate Medical Education included medical decision-making as a core competency in several specialties. To date, the ability to demonstrate and measure a pedagogical evolution of medical judgment in a medical education program has been limited. In this study, we aim to examine differences in medical decision-making of physician groups in distinctly different stages of their postgraduate career.

methodsThe study recruited physicians with a wide spectrum of disciplines and levels of experience to take part in 4 medical simulations divided into 2 categories, abdominal pain (biliary colic [BC] and renal colic [RC]) or chest pain (cardiac ischemia with ST-segment elevation myocardial infarction [STEMI] and pneumothorax [PTX]). Evaluation of medical decision-making used the Medical Judgment Metric (MJM). The targeted selection criteria for the physician groups are administrative physicians (APs), representing those with the most experience but whose current duties are largely administrative; resident physicians (RPs), those enrolled in postgraduate medical or surgical training; and mastery level physicians (MPs), those deemed to have mastery level experience. The study measured participant demographics, physiological responses, medical judgment scores, and simulation time to case resolution. Outcome differences were analyzed using Fisher exact tests with post hoc Bonferroni-adjusted

resultsA total of n = 30 physicians were recruited for the study with n = 10 participants in each physician group. No significant differences were found in baseline demographics between groups. Analysis of simulations showed a significant (

conclusionsPhysicians in distinctly different stages of their respective postgraduate career differed in several domains when assessed through a consistent high-fidelity medical simulation program. Further studies are warranted to accurately assess pedagogical differences over the medical judgment lifespan of a physician.

Indexed as

clinical judgmentdecision-makingknowledge retentionmedical educationmedical judgmentsimulationSkill retention

Identifiers

PMID32656357
PMCPMC7333496
OpenAlexW3039983582

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.