Learning from Missed Opportunities Through Reflective Practice

Astik, Gopi J.; Olson, Andrew

doi:10.1016/j.ccc.2021.09.003

Cited by 3 publications

(3 citation statements)

References 35 publications

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“…Training techniques which directly benefit clinical skills as well as the ‘softer skills’ needed in dermatology are vital 1,2,13 . We observed that MLT fostered a sense of personal enrichment and enhanced reflective practice in participants, thereby equipping trainees with a mechanism for personal analysis in how to improve clinical skills and respond to diagnostic uncertainty or error 28,29 …”

Section: Discussionmentioning

confidence: 93%

Music literacy training in dermatology: A mixed methods cohort study of postgraduate education

Matthews,

Wray,

Peilober‐Richardson

et al. 2023

JEADV Clinical Practice

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BackgroundWe have previously pioneered arts‐based training to enhance clinical skills in senior and resident dermatologists. However, the utility of music to support the development of dermatological skills such as listening, observation, description and communication is unexplored.ObjectivesWe hypothesised that music literacy training (MLT) would enhance the clinical dermatology skills of newly qualified doctors and could be effectively delivered in a single‐session virtual format.MethodsOur training comprised a 2.5‐h course held in October 2021 on the virtual meeting platform Zoom. The course was led by a music educator and included sessions which placed particular emphasis on listening to music, discriminating auditory cues to interpret imagery and meaning, and describe this to others. Participants explored concepts such as pitch, melody, pace, rhythm, dynamics and timbre by working collaboratively, independently and in small break‐out groups. All participants documented their learning journey through pre‐ and post‐course reflective essays and the training was evaluated by a pre‐ and post‐course dermatology clinical assessment.ResultsMusic served as a catalyst for reflection and discussion, supporting significant improvement key clinical skills such as listening, clinical observation and description in newly qualified doctors. Participants reported increased confidence communicating with others and found the course structure enjoyable and fun.ConclusionsCombined qualitative and quantitative evidence highlights the benefit of MLT in developing key clinical skills in newly qualified doctors which is effective when delivered in a single‐session, virtual format.

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Section: Discussionmentioning

confidence: 93%

Music literacy training in dermatology: A mixed methods cohort study of postgraduate education

Matthews,

Wray,

Peilober‐Richardson

et al. 2023

JEADV Clinical Practice

View full text Add to dashboard Cite

show abstract

“…Similarly, examining the impact of errors on patients and the clinicians involved humanizes the issue for PRC participants. Recognizing errors without reflecting on their impact can make the review process seem like an administrative exercise rather than an important opportunity for learning and improvement[ 74 ]. The reflection should involve providing feedback to clinicians on their decision-making.…”

Section: Introductionmentioning

confidence: 99%

Ten misconceptions regarding decision-making in critical care

Ramaswamy,

Sparling,

Chang

et al. 2024

World J Crit Care Med

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Diagnostic errors are prevalent in critical care practice and are associated with patient harm and costs for providers and the healthcare system. Patient complexity, illness severity, and the urgency in initiating proper treatment all contribute to decision-making errors. Clinician-related factors such as fatigue, cognitive overload, and inexperience further interfere with effective decision-making. Cognitive science has provided insight into the clinical decision-making process that can be used to reduce error. This evidence-based review discusses ten common misconceptions regarding critical care decision-making. By understanding how practitioners make clinical decisions and examining how errors occur, strategies may be developed and implemented to decrease errors in Decision-making and improve patient outcomes.

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“…Such interventions, referred to as cognitive reasoning tools in this study, are aimed at improving clinical reasoning and decision-making skills by improving clinicians’ intuitive and rational processing during diagnosis 3. Examples include checklists,12 reflective practices,2 7 12–15 cognitive forcing strategies12 and clinical decision support systems 12 16. Experiments testing the effectiveness of cognitive reasoning tools are relatively scarce,3 17 but overall the current literature indicates these tools could improve diagnostic accuracy.…”

Section: Introductionmentioning

confidence: 99%

Effect on diagnostic accuracy of cognitive reasoning tools for the workplace setting: systematic review and meta-analysis

Staal¹,

Hooftman

Gunput³

et al. 2022

BMJ Qual Saf

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BackgroundPreventable diagnostic errors are a large burden on healthcare. Cognitive reasoning tools, that is, tools that aim to improve clinical reasoning, are commonly suggested interventions. However, quantitative estimates of tool effectiveness have been aggregated over both workplace-oriented and educational-oriented tools, leaving the impact of workplace-oriented cognitive reasoning tools alone unclear. This systematic review and meta-analysis aims to estimate the effect of cognitive reasoning tools on improving diagnostic performance among medical professionals and students, and to identify factors associated with larger improvements.MethodsControlled experimental studies that assessed whether cognitive reasoning tools improved the diagnostic accuracy of individual medical students or professionals in a workplace setting were included. Embase.com, Medline ALL via Ovid, Web of Science Core Collection, Cochrane Central Register of Controlled Trials and Google Scholar were searched from inception to 15 October 2021, supplemented with handsearching. Meta-analysis was performed using a random-effects model.ResultsThe literature search resulted in 4546 articles of which 29 studies with data from 2732 participants were included for meta-analysis. The pooled estimate showed considerable heterogeneity (I2=70%). This was reduced to I2=38% by removing three studies that offered training with the tool before the intervention effect was measured. After removing these studies, the pooled estimate indicated that cognitive reasoning tools led to a small improvement in diagnostic accuracy (Hedges’ g=0.20, 95% CI 0.10 to 0.29, p<0.001). There were no significant subgroup differences.ConclusionCognitive reasoning tools resulted in small but clinically important improvements in diagnostic accuracy in medical students and professionals, although no factors could be distinguished that resulted in larger improvements. Cognitive reasoning tools could be routinely implemented to improve diagnosis in practice, but going forward, more large-scale studies and evaluations of these tools in practice are needed to determine how these tools can be effectively implemented.PROSPERO registration numberCRD42020186994.

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Learning from Missed Opportunities Through Reflective Practice

Cited by 3 publications

References 35 publications

Music literacy training in dermatology: A mixed methods cohort study of postgraduate education

Music literacy training in dermatology: A mixed methods cohort study of postgraduate education

Ten misconceptions regarding decision-making in critical care

Effect on diagnostic accuracy of cognitive reasoning tools for the workplace setting: systematic review and meta-analysis

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