CoChat
Sign Up
Cited by 382Clinical Reasoning and Diagnostic SkillsReflective Practices in EducationInnovations in Medical Education

Effects of reflective practice on the accuracy of medical diagnoses

Mamede, Silvia, Schmidt, Henk G, Penaforte, Júlio César·2008·Medical Education
DOI 10.1111/j.1365-2923.2008.03030.x
Open this paper in CoChat — free account

Abstract

Context Reflective practice has been suggested to be an important instrument in improving clinical judgement and developing medical expertise. Empirical evidence supporting this suggestion, however, is absent. This paper reports on an experiment conducted to study the effects of reflective practice on diagnostic accuracy. Methods Participants were 42 internal medicine residents in hospitals in 2 states in the northeast of Brazil. They diagnosed 16 clinical cases. The experiment employed a repeated measures design, with 2 independent variables: the complexity of clinical cases (simple or complex), and the reasoning approach induced to diagnose the case (participants were instructed to diagnose each case either through pattern recognition or reflective reasoning). The dependent variable was the accuracy of the diagnosis provided for each case. All participants participated in each of the 2 levels of both independent variables. Results A main effect of case complexity emerged. There was no statistically significant main effect of reflective practice. However, a significant interaction effect was found between case complexity and mode of processing (F[1,41] = 4.48, P < 0.05), indicating that although reflective practice did not make a difference to accuracy of diagnosis in simple cases, it had a positive effect when diagnosing complex cases. Conclusions Reflective practice had a positive effect on diagnosis of complex, unusual cases. Non‐analytical reasoning was shown to be as effective as reflective reasoning for diagnosing routine clinical cases. Findings support the idea that reflective practice may particularly improve diagnoses in situations of uncertainty and uniqueness, reducing diagnostic errors.

Integrity signals

Registry

Crossref · 10.1111/j.1365-2923.2008.03030.x

Cites

24 of 24 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Methods such as reflective medical practice and debiasing through feedback can help reduce the number of cognitive errors.

    “methods such as reflective medical practice36, which help clinicians enhance their ability to navigate complex cases37, or debiasing through feedback to identify and correct cognitive biases38 can help in reducing the number of cognitive errors.”

    From Large Language Models lack essential metacognition for reliable medical reasoning (2025) · cites this paper as [37]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Mamede, S., Schmidt, H. G., & Penaforte, J. C.
Affiliations
Erasmus University Rotterdam (NL)
ORCID
Schmidt, Henk G
Venue
Medical Education
Publisher
Wiley
Published
2008-04-11
Volume
42
Issue
5
Pages
468-475
ISSN
  • 0308-0110 (ISSN-L)
  • 1365-2923
DOI
10.1111/j.1365-2923.2008.03030.x
OpenAlex
W1975402326
Cited by
382
References
24
Citations by year
2026: 31 · 2025: 9 · 2024: 26 · 2023: 19 · 2022: 29 · 2021: 27 · 2020: 26 · 2019: 26 · 2018: 19 · 2017: 20 · 2016: 20 · 2015: 24 · 2014: 23 · 2013: 26 · 2012: 21
FWCI
8.27
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Medical Education (publishedVersion)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
Topics
  • Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
  • Social Sciences › Education › Reflective Practices in Education
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
Keywords
reflective practice, diagnostic accuracy, clinical judgment, internal medicine residents, case complexity, pattern recognition, reflective thinking, diagnostic errors, clinical reasoning
MeSH terms
Brazil, Clinical Competence, Diagnosis, Internal Medicine, Internship and Residency, Thinking

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review