ERIC Number: EJ1074026
Record Type: Journal
Publication Date: 2015-Oct
Abstractor: As Provided
Reference Count: 19
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.
Advances in Health Sciences Education, v20 n4 p1053-1060 Oct 2015
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 (0.27 ± 0.53 errors per ECG vs. 0.04 ± 0.43, F[subscript 1,15] = 8.1, p = 0.01, ?[superscript 2] = 0.20). Checklist use was associated with enhanced analytic scrutiny in all eye tracking measures assessed (F[subscript 6,10] = 6.0, p = 0.02). 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.
Descriptors: Clinical Diagnosis, Check Lists, Medical Evaluation, Eye Movements, Decision Making, Diagnostic Tests, Heart Disorders, Cues, Error Correction, Correlation
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Publication Type: Journal Articles; Reports - Research
Education Level: N/A
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