Using metacognition to analyze a misdiagnosis case in high-fidelity simulation
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista Brasileira de Educação Médica (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-55022021000200217 |
Resumo: | Abstract: Introduction: Medical teams constantly work with patients in critical conditions and complex environments. Within these environments, it is understood that cognitive, metacognitive and affective processes coexist, promoting or preventing an adequate performance1),(2. In this study, a case of medical misdiagnosis is analyzed from a metacognitive perspective. Objectives: 1- Describe the thinking processes that led to the misdiagnosis, 2- Investigate possible contributions of metacognitive processes to medical education. Methods: Group interview3 with the winning team of a simulation contest for attending critical patients held at a national medical education congress. Content analysis4, coded by Atlas-ti™, according to Efklides5, followed by the extraction of empirical categories in the SimpleMind™ Mind Map Editor. The study was registered (CAAE 96007018.5.0000.5286) and approved (Opinion No. 2,938,945) by the Research Ethics Committee of Institute of Collective Health Studies at the Federal University of Rio de Janeiro. Results: Before the contest, the team predicted possible scenarios. During the contest, the simulated scenario presented to the participants was similar to one of the previously predicted scenarios. It was then observed that the team unconsciously biased all their reasoning aiming to confirm the previously predicted diagnosis. Different metacognitive mechanisms involved in this process are described. The team had sufficient knowledge to establish the correct diagnosis but did not do it due to the distortion of their thinking processes. This case illustrates the fact that, to practice medicine, knowledge is not enough; learning to think is also necessary. In addition, a proposal for a theoretical framework is established, where the simulation presents itself as a problematizing methodology, providing a context where metacognition and the Maguerez Arch6 are harmoniously integrated with Ausubel’s Meaningful Learning Theory7),(8 for professional competence6 development. Conclusions: It is concluded that metacognition can elucidate events such as those described here, also suggesting that its teaching and practice could contribute to the reduction in medical misdiagnosis. |
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Using metacognition to analyze a misdiagnosis case in high-fidelity simulationMetacognitionLearningStudentsSimulation TrainingDiagnostic ErrorsClinical Decision-MakingAbstract: Introduction: Medical teams constantly work with patients in critical conditions and complex environments. Within these environments, it is understood that cognitive, metacognitive and affective processes coexist, promoting or preventing an adequate performance1),(2. In this study, a case of medical misdiagnosis is analyzed from a metacognitive perspective. Objectives: 1- Describe the thinking processes that led to the misdiagnosis, 2- Investigate possible contributions of metacognitive processes to medical education. Methods: Group interview3 with the winning team of a simulation contest for attending critical patients held at a national medical education congress. Content analysis4, coded by Atlas-ti™, according to Efklides5, followed by the extraction of empirical categories in the SimpleMind™ Mind Map Editor. The study was registered (CAAE 96007018.5.0000.5286) and approved (Opinion No. 2,938,945) by the Research Ethics Committee of Institute of Collective Health Studies at the Federal University of Rio de Janeiro. Results: Before the contest, the team predicted possible scenarios. During the contest, the simulated scenario presented to the participants was similar to one of the previously predicted scenarios. It was then observed that the team unconsciously biased all their reasoning aiming to confirm the previously predicted diagnosis. Different metacognitive mechanisms involved in this process are described. The team had sufficient knowledge to establish the correct diagnosis but did not do it due to the distortion of their thinking processes. This case illustrates the fact that, to practice medicine, knowledge is not enough; learning to think is also necessary. In addition, a proposal for a theoretical framework is established, where the simulation presents itself as a problematizing methodology, providing a context where metacognition and the Maguerez Arch6 are harmoniously integrated with Ausubel’s Meaningful Learning Theory7),(8 for professional competence6 development. Conclusions: It is concluded that metacognition can elucidate events such as those described here, also suggesting that its teaching and practice could contribute to the reduction in medical misdiagnosis.Associação Brasileira de Educação Médica2021-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-55022021000200217Revista Brasileira de Educação Médica v.45 n.2 2021reponame:Revista Brasileira de Educação Médica (Online)instname:Associação Brasileira de Educação Médica (ABEM)instacron:ABEM10.1590/1981-5271v45.2-20200255.inginfo:eu-repo/semantics/openAccessPeixoto,Mauricio Abreu PintoBrandão,Marcos Antônio GomesPereira Junior,Gerson AlvesCampos,Juliana FariaSouto,Jaqueline da Silva Soareseng2021-06-09T00:00:00Zoai:scielo:S0100-55022021000200217Revistahttp://www.educacaomedica.org.br/https://old.scielo.br/oai/scielo-oai.phprevista@abem-educmed.org.br||revista@educacaomedica.org.br1981-52710100-5502opendoar:2021-06-09T00:00Revista Brasileira de Educação Médica (Online) - Associação Brasileira de Educação Médica (ABEM)false |
dc.title.none.fl_str_mv |
Using metacognition to analyze a misdiagnosis case in high-fidelity simulation |
title |
Using metacognition to analyze a misdiagnosis case in high-fidelity simulation |
spellingShingle |
Using metacognition to analyze a misdiagnosis case in high-fidelity simulation Peixoto,Mauricio Abreu Pinto Metacognition Learning Students Simulation Training Diagnostic Errors Clinical Decision-Making |
title_short |
Using metacognition to analyze a misdiagnosis case in high-fidelity simulation |
title_full |
Using metacognition to analyze a misdiagnosis case in high-fidelity simulation |
title_fullStr |
Using metacognition to analyze a misdiagnosis case in high-fidelity simulation |
title_full_unstemmed |
Using metacognition to analyze a misdiagnosis case in high-fidelity simulation |
title_sort |
Using metacognition to analyze a misdiagnosis case in high-fidelity simulation |
author |
Peixoto,Mauricio Abreu Pinto |
author_facet |
Peixoto,Mauricio Abreu Pinto Brandão,Marcos Antônio Gomes Pereira Junior,Gerson Alves Campos,Juliana Faria Souto,Jaqueline da Silva Soares |
author_role |
author |
author2 |
Brandão,Marcos Antônio Gomes Pereira Junior,Gerson Alves Campos,Juliana Faria Souto,Jaqueline da Silva Soares |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Peixoto,Mauricio Abreu Pinto Brandão,Marcos Antônio Gomes Pereira Junior,Gerson Alves Campos,Juliana Faria Souto,Jaqueline da Silva Soares |
dc.subject.por.fl_str_mv |
Metacognition Learning Students Simulation Training Diagnostic Errors Clinical Decision-Making |
topic |
Metacognition Learning Students Simulation Training Diagnostic Errors Clinical Decision-Making |
description |
Abstract: Introduction: Medical teams constantly work with patients in critical conditions and complex environments. Within these environments, it is understood that cognitive, metacognitive and affective processes coexist, promoting or preventing an adequate performance1),(2. In this study, a case of medical misdiagnosis is analyzed from a metacognitive perspective. Objectives: 1- Describe the thinking processes that led to the misdiagnosis, 2- Investigate possible contributions of metacognitive processes to medical education. Methods: Group interview3 with the winning team of a simulation contest for attending critical patients held at a national medical education congress. Content analysis4, coded by Atlas-ti™, according to Efklides5, followed by the extraction of empirical categories in the SimpleMind™ Mind Map Editor. The study was registered (CAAE 96007018.5.0000.5286) and approved (Opinion No. 2,938,945) by the Research Ethics Committee of Institute of Collective Health Studies at the Federal University of Rio de Janeiro. Results: Before the contest, the team predicted possible scenarios. During the contest, the simulated scenario presented to the participants was similar to one of the previously predicted scenarios. It was then observed that the team unconsciously biased all their reasoning aiming to confirm the previously predicted diagnosis. Different metacognitive mechanisms involved in this process are described. The team had sufficient knowledge to establish the correct diagnosis but did not do it due to the distortion of their thinking processes. This case illustrates the fact that, to practice medicine, knowledge is not enough; learning to think is also necessary. In addition, a proposal for a theoretical framework is established, where the simulation presents itself as a problematizing methodology, providing a context where metacognition and the Maguerez Arch6 are harmoniously integrated with Ausubel’s Meaningful Learning Theory7),(8 for professional competence6 development. Conclusions: It is concluded that metacognition can elucidate events such as those described here, also suggesting that its teaching and practice could contribute to the reduction in medical misdiagnosis. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-55022021000200217 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-55022021000200217 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1981-5271v45.2-20200255.ing |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Brasileira de Educação Médica |
publisher.none.fl_str_mv |
Associação Brasileira de Educação Médica |
dc.source.none.fl_str_mv |
Revista Brasileira de Educação Médica v.45 n.2 2021 reponame:Revista Brasileira de Educação Médica (Online) instname:Associação Brasileira de Educação Médica (ABEM) instacron:ABEM |
instname_str |
Associação Brasileira de Educação Médica (ABEM) |
instacron_str |
ABEM |
institution |
ABEM |
reponame_str |
Revista Brasileira de Educação Médica (Online) |
collection |
Revista Brasileira de Educação Médica (Online) |
repository.name.fl_str_mv |
Revista Brasileira de Educação Médica (Online) - Associação Brasileira de Educação Médica (ABEM) |
repository.mail.fl_str_mv |
revista@abem-educmed.org.br||revista@educacaomedica.org.br |
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1754303008673366016 |