To investigate the role of biomedical and
diagnostic inferences in clinical reasoning
of advanced medical students and
experienced family physicians using a
lexical decision task.
In 2002, 15 family physicians and 20
fourth-year medical students at
Maastricht University medical school in
The Netherlands were instructed to
carefully study 60 short clinical texts
consisting of signs and symptoms
associated with a particular disease.
Participants read the texts on a computer
screen and responded using a computer
keyboard. Each text was followed by a
target item (i.e., biomedical item,
diagnostic item, or a nonword).
Participants had to decide as quickly and
accurately as possible whether the
presented target item was a word or a
nonword. For both groups, mean
response time and mean error rate for all
levels of item type were analyzed.
Findings indicate that both physicians
and medical students judged diagnostic
target items faster and more accurately
than biomedical target items. However,
physicians were considerably faster than
were students on judging biomedical and
diagnostic target items.
These findings are largely in line with
knowledge encapsulation in that
biomedical knowledge still plays a
prominent role in the physician’s clinical