Bolstering diagnostic reasoning skills with adaptive learning

Abstract

Purpose: Adaptive learning emerges when precise assessment informs delivery of educational materials. This study will demonstrate how data from Human Dx, a case-based e-learning platform, can characterize an individual’s diagnostic reasoning skills, and deliver tailored content to improve accuracy.

Methods: Pearson Chi-square analysis was used to assess variability in accuracy across three groups of participants (attendings, residents, and medical students) and three categories of cases (core medical, surgical, and other). Logistic regression analyses were conducted to explore the relationship between solve duration and accuracy. Mean accuracy and duration were calculated for 370 individuals. Repeated measures analysis of variance (ANOVA) were used to assess variability for an individual solver across the three categories.

Results: There were significant differences in accuracy across the three groups and the three categories (p < 0.001). Individual solvers have significant variance in accuracy across the three categories. Shorter solve duration predicted higher accuracy. Patterns of performance were identified; four profiles are highlighted to demonstrate potential adaptive learning interventions.

Conclusions: Human Dx can assess diagnostic reasoning skills. When weaknesses are identified, adaptive learning strategies can push content to promote skill development. This has implications for customizing curricular elements to improve the diagnostic skills of healthcare professionals.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article. Dr. Nundy and Dr. Rabner are employed by the Human Diagnosis Project Nonprofit.

Additional information

Funding

Dr. Wright is supported as the Anne Gaines and G. Thomas Miller Professor of Medicine through the Johns Hopkins Center for Innovative Medicine. The Human Diagnosis Project is supported by funding from the Gordon and Betty Moore Foundation, American Board of Internal Medicine Foundation, and the American Hospital Association.

Notes on contributors

Miranda Huffman

Miranda Huffman, MD, MEd, is an Associate Professor, Family Medicine Clerkship Director, and the Vice Chair of Education for the Department of Community and Family Medicine at the University of Missouri – Kansas City.

Sarah Gustafson

Sarah Gustafson, MD, is a Pediatric Chief Resident at the UCLA Pediatric Residency Program. Her interests are in diversity and inclusion, and global health medical education.

Souvik Chatterjee

Souvik Chatterjee, MD, is a Critical Care Fellow at the National Institutes of Health Clinical Center.

Marc Rabner

Marc Rabner, MD, MPH, is a Medicine Team member at the Human Diagnosis Project Nonprofit and a Pediatric Hospitalist at the Children's Hospital of Philadelphia.

Shantanu Nundy

Shantanu Nundy, MD, is the Director of the Human Diagnosis Project Nonprofit and a professorial lecturer in health policy at the George Washington University Milken Institute of Public Health. He is also a practicing primary care physician in Washington, DC.

Mary M. Gerkovich

Mary M. Gerkovich, PhD, is an Adjunct Emeritus Associate Professor in the Department of Biomedical and Health Informatics at the University of Missouri – Kansas City School of Medicine.

Scott M. Wright

Scott M. Wright, MD, is a professor in the Department of Medicine at Johns Hopkins University School of Medicine. He is the Division Chief of General Internal Medicine at Johns Hopkins Bayview Medical Center and he serves as the Director of Hopkins' Miller Coulson Academy of Clinical Excellence.