ROLE OF PERSONALITY, COGNITIVE LOAD AND WORKLOAD IN DIAGNOSTIC DECISION MAKING

Saturday, January 9, 2016
Foyer, G/F (Jockey Club School of Public Health and Primary Care Building at Prince of Wales Hospital)

Lakshmi Mahadevan, M.Phil and Azizuddin Khan, Ph.D, Indian Institute of Technology Bombay, India, Mumbai, India
Purpose:

Diagnostic decision making is the process to determine whether or not a patient has a certain condition or disease. The aim of the present study is to understand how medical interns make diagnostic decisions. For this purpose they were given two case studies. The cases presented were designed in such a way that there will be some level of conflict involved in it.The case studies are developed based on excerpts taken from the real case studies published in the New England journal of Medicine (NEJM) website and a medical case book entitled “Case Files: Internal medicine”. Certain modifications especially relating to demographic information has been made so as to make it appropriate to the Indian Scenario. The case studies were redesigned with the help of two practicing physicians. The case studies thus developed had gone through an expert validation procedure. This was done by 3 experts who are involved in teaching and practice of medicine and had more than 10 years of experience. Data were collected from 4 different medical colleges. Some of the participants were reached through the house surgeons association of concerned medical college and others through personal contact. The material was administered to 17 house surgeons who consented to take part in the research.The data thus collected was compared with existing standardized protocol and relevant medical literature to see the extent to which participants adhered to the protocol while making diagnostic decisions.

Method(s): Both exploratory and causal research designs were used in the study. The ANOVA and correlation were employed to analyze the data.

Result(s): The results showed that as cognitive load increases diagnostic decision accuracy also declined.  Further results revealed that conscientiousness and extroversion were associated with fewer errors in diagnostic decision making as compared to opened and neuroticism. The results were also corroborated with qualitative data.

Conclusion(s): Cognitve load and personality factors affect diagnostic decision making. The findings have practical implication in physician’s diagnostic decision making. We are in the middle of data collection. This is the result of pilot study. Hopefully, we will be able to say something concretely once we collect sufficient data.