Comparação entre efeitos da reflexão deliberada e do diagnóstico diferencial na retenção de dados clínicos na memória de longo prazo entre estudantes do internato de medicina

• Ano de defesa: 2024
• Autor(a) principal: Oliveira, Luis Gustavo da Silva
• Orientador(a): Miguel, Rita de Cássia Corrêa
• Banca de defesa: Pereira, Alexandre de Araújo, Santos, Silvana Maria Elói
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade José do Rosário Vellano
• Programa de Pós-Graduação: Programa de Mestrado em Ensino em Saúde
• Departamento: Pós-Graduação
• País: Brasil
• Palavras-chave em Português: Educação médica; Pensamento crítico; Doenças - Diagnóstico
• Área do conhecimento CNPq: CIENCIAS DA SAUDE::MEDICINA
• Link de acesso: http://tede2.unifenas.br:8080/jspui/handle/jspui/352

Introduction: deliberate reflection has been shown in experimental studies to be an effective strategy in the diagnostic ability of complex clinical problems, functioning as an instrument for improving clinical performance throughout professional life. However, compared to the differential diagnosis strategy, it is still unknown what its potential is to store the history data of analyzed patients in the long-term memory of medical students. The hypothesis was that students who reflected on the cases through deliberate reflection would perform better on the recall task than those who carried out differential diagnosis. Objective: to understand the effect of deliberate reflection on the memory retention of clinical data, compared to the differential diagnosis strategy, among medical internship students. Method: experimental, quantitative, single-center study with medical students. Students were divided into two groups and instructed to diagnose clinical cases through deliberate reflection, when students generate hypotheses and reflect on them, or through differential diagnosis, when students generate a more likely hypothesis and two alternative diagnoses, without reflecting. about such hypotheses. After seven days, they performed a recall task of the data presented in the clinical cases from the previous week and the amount of information recalled about the cases was considered to measure the inmates' long-term memory retention and cognitive processing, and then compared between the groups. Results: sixty-three interns participated in both stages of the study, 34 in the reflection group and 29 in the differential diagnosis group. The average diagnostic accuracy of students in the case analysis phase was 20%. There was no difference in the amount of relevant information about clinical cases recalled between the experimental and control groups (p=0.54). Conclusion: The present study found no difference between the deliberate reflection group and the differential diagnosis group in the retention of information in long-term memory. The low diagnostic accuracy resulting from the cognitive load, probably very high for the population studied, may have interfered with data retention clinicians in long-term memory during diagnostic reasoning, making comparisons between groups difficult. This was, as far as we know, the first study that sought to evaluate the potential of deliberate reflection in storing clinical data in long-term memory compared to the traditional strategy of differential diagnosis. New studies in this line of research have important potential to increase the learning acquired through solving clinical cases.