The present study was undertaken to examine the hypothesis that the intermediate effect in clinical case recall is partly explained by experts' lower motivation to write down everything they remember when asked for free recall. Medical experts and students were presented with two clinical cases, which they had to read, diagnose, and recall. Participants received an instruction before processing the cases that aimed at minimizing motivation in one condition, and enhance motivation in another. A third condition received a standard instruction, comparable to previous clinical case representation studies. The results showed that medical experts' clinical case processing mode is robust and insensitive to pressure induced by a social comparison instruction. In all conditions, recall data showed an intermediate effect, indicating encapsulated processing by the expert group. Moreover, there were no differences between the conditions in diagnostic accuracy, number of summaries in recall, and study time on the cases. Although experts showed that they were affected by the instruction, their processing mode remained stable over the three conditions. Expert physicians, even under conditions of considerable pressure, process clinical cases in an encapsulated mode.

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Instructional Science: an international journal of learning and cognition
Department of Psychology

de Bruin, A., van de Wiel, M., Rikers, R., & Schmidt, H. (2005). Examining the stability of experts' clinical case processing: An experimental manipulation. Instructional Science: an international journal of learning and cognition, 33(3), 251–270. doi:10.1007/s11251-005-3598-8