VISUAL ANALOGIES IN DERMATOLOGY: IMPACT ON THE DIAGNOSTIC ACUMEN OF UNDERGRADUATE MEDICAL STUDENTS

Authors

  • Denise M. Assunção Universidade José do Rosário Vellano, Belo Horizonte, Minas Gerais, Brazil orcid.org/0000-0003-0657-3398
  • Alexandre S. Moura Universidade José do Rosário Vellano, Belo Horizonte, Minas Gerais, Brazil orcid.org/0000-0002-4818-5425
  • Lígia M. C. Ribeiro Universidade José do Rosário Vellano, Belo Horizonte, Minas Gerais, Brazil orcid.org/0000-0002-4277-3066

DOI:

https://doi.org/10.46827/ejes.v9i7.4351

Keywords:

dermatology, learning, analogy, medical education

Abstract

Background: Visual analogies are much used in medical education; however, their effect on the development of clinical reasoning has yet to be investigated. In fields such as dermatology in which reasoning is predominantly based on the recognition of visual patterns, analogies may be even more useful. Objectives: To investigate the effects of the use of visual analogies on the accuracy of undergraduate medical students in diagnosing skin disorders. Methods: Sixty-four fourth-year medical students were divided into two groups to train in diagnosing skin diseases, either using visual analogies (study group) or from descriptions of elementary lesions (control group). The accuracy of the groups in diagnosing skin disorders was evaluated at 30 and 90 days after training, with their ability to create analogies also being tested at the 90-day evaluation. Results: Diagnostic accuracy improved in both groups when the students’ performance before training was compared with their accuracy 30 days later (study group: 7.24±1.71 versus 8.76±1.83 respectively, p<0.001; control group: 7.42±2.02 versus 8.27±1.42, respectively, p<0.001). Results were similar 90 days after training. There was no statistically significant difference in diagnostic accuracy between the groups at 30 or 90 days following training (p=0.378). The study group performed better than the control group at making analogies (p<0.001), but there was no statistically significant correlation between diagnostic accuracy and the ability to make analogies (r- -9,15; p=0.437). Conclusion: Diagnostic accuracy improved similarly in both groups. Other formats of visual analogies should be evaluated to clarify their role in developing diagnostic skills in dermatology.

 

Article visualizations:

Hit counter

Author Biographies

  • Denise M. Assunção, Universidade José do Rosário Vellano, Belo Horizonte, Minas Gerais, Brazil orcid.org/0000-0003-0657-3398

    Denise Maria Assunção is a faculty member of the medicine course at UNIFENAS -BH, having completed her master's degree in Health Sciences - line of research in clinical reasoning.

  • Alexandre S. Moura, Universidade José do Rosário Vellano, Belo Horizonte, Minas Gerais, Brazil orcid.org/0000-0002-4818-5425

    Alexandre Moura is a faculty member of the Master´s Degree Program in Health Professional Education at UNIFENAS-BH and his field of research interest includes clinical reasoning.

  • Lígia M. C. Ribeiro, Universidade José do Rosário Vellano, Belo Horizonte, Minas Gerais, Brazil orcid.org/0000-0002-4277-3066

    Ligia Maria Cayres is a faculty member of the Master´s Degree Program in Health Professional Education at UNIFENAS-BH and his field of research interest includes clinical reasoning.

References

Aldridge RB, Glodzik D, Ballerini L, Fisher RB, Rees JL. Utility of non-rule-based visual matching as a strategy to allow novices to achieve skin lesion diagnosis. Acta Derm Venereol. 2011;91(3):279-283.

Norman GR, Rosenthal D, Brooks LR, Allen SW, Muzzin LJ. The development of expertise in dermatology. Arch Dermatol. 1989;125(8):1063-1068.

Norman GR, Coblentz CL, Brooks LR, Babcook CJ. Expertise in visual diagnosis: a review of the literature. Acad Med.1992;67(10 Suppl):S78-S83.

Lowenstein EJ, Sidlow R. Cognitive and visual diagnostic errors in dermatology: part 1. Br J Dermatol. 2018;179(6):1263-1269.

Kulatunga-Moruzi C, Brooks LR, Norman GR. Coordination of analytic and similarity-based processing strategies and expertise in dermatological diagnosis. Teach Learn Med. 2001;13(2):110-116.

Sternberg RJ. Psicologia cognitiva. [Cognitive psychology]. 5th ed. São Paulo: Cengage Learning; 2016.

Clark RA, Rietschel RL. The cost of initiating appropriate therapy for skin diseases: a comparison of dermatologists and family physicians. J Am Acad Dermatol. 1983;9(5):787-796.

Kulatunga-Moruzi C, Brooks LR, Norman GR. Using comprehensive feature lists to bias medical diagnosis. J Exp Psychol Learn Mem Cogn. 2004;30(3):563-572.

Eva KW. What every teacher needs to know about clinical reasoning. Med Educ. 2005;39(1):98-106.

Harrington E, Clyne B, Wesseling N, et al. Diagnosing malignant melanoma in ambulatory care: a systematic review of clinical prediction rules. BMJ Open. 2017;7:e014096.

Guégan S, Steichen O, Soria A. Literature review of perceptual learning modules in medical education: what can we conclude regarding dermatology? Ann Dermatol Venereol. 2021;148(1):16-22.

Brown NH, Robertson KM, Bisset YC, Rees JL. Using a structured image database, how well can novices assign skin lesion images to the correct diagnostic grouping? J Invest Dermatol. 2009;129(10):2509-2512.

Aldridge RB, Maxwell SS, Rees JL. Dermatology undergraduate skin cancer training: a disconnect between recommendations, clinical exposure and competence. BMC Med Educ. 2012;12:27.

Vallarelli AF, Silva VMCF, Souza EM. Dermatologia comparativa. [Comparative dermatology]. An Bras Dermatol. 1999;74(1):75-76.

Gentner D, Holyoak KJ. Reasoning and learning by analogy. Am Psychol. 1997;52(1):32-34.

Frieden IJ, Dolev JC. Medical analogies: their role in teaching dermatology to medical professionals and patients. J Am Acad Dermatol. 2005;53(5):863-866.

Ausubel DP. Aquisição e retenção de conhecimentos: uma perspectiva cognitiva. [Acquisition and retention of knowledge: a cognitive perspective]. Porto: Paralelo; 2003.

Santos SCS, Téran AF. Aprendizagem significativa, modelos mentais e analogias no contexto construtivista: uma aproximação possível para a educação em ciências. [Meaningful learning, mental models and analogies in the constructivist context: a possible approach to science education]. In: Santos SCS, Téran AF. Educação em Ciências na Amazônia: múltiplos olhares. [Science Education in the Amazon: multiple perspectives]. Manaus: Editora UEA; 2010:203.

Pena GP, Andrade-Filho JS. Analogies in medicine: valuable for learning, reasoning, remembering and naming. Adv Health Sci Educ Theory Pract. 2010;15(4):609-619.

Gentner D, Markman AB. Structure mapping in analogy and similarity. Am Psychol. 1997;52(1)45-56.

Blanchette I, Dunbar K. How analogies are generated: the roles of structural and superficial similarity. Mem Cognit. 2000;28(1):108-124.

Andrade Filho JS. Analogias em medicina - Parte I. [Analogies in Medicine - Part I]. Rev Méd Minas Gerais. 2008;18(3):220-224.

Moreira MA. A teoria da aprendizagem significativa de Ausubel: teorias da aprendizagem. [Ausubel's theory of meaningful learning: theories of learning]. São Paulo: EPU; 1999.

Friedlander MJ, Andrews L, Armstrong EG, et al. What can medical education learn from the neurobiology of learning? Acad Med. 2011;86(4):415-420.

Downloads

Published

2022-06-28

Issue

Vol. 9 No. 7 (2022)

Section

Articles

License

Authors who publish with this journal agree to the following terms:

Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).