Name
Diagnosing Accurately through Practice: Exploring the Role of Deliberate
Practice in the Learning of Diagnostic Reasoning
Date & Time
Sunday, June 7, 2026, 4:19 PM - 4:34 PM
Location Name
Lamar C
Speakers
Authors
Hei Ching Kristy Cheung, University of Toronto
Nicole Woods, University of Toronto
Maria Mylopoulos, University of Toronto
Presentation Topic(s)
Instructional Methods
Description
PURPOSE
Deliberate practice (DP) is an instructional approach that emphasizes
purposeful repetition of carefully constructed tasks and has been shown to be
effective for developing procedural skills in medical education. However, its
role in fostering more complex aspects of clinical expertise, such as
diagnostic reasoning, remains underexplored. As current healthcare
environment demands clinicians to cultivate adaptive expertise, it is
necessary to determine whether DP supports the development of adaptive
expertise in diagnostic reasoning.
METHODS
A multi-phase experimental study was conducted to determine whether DP
supports mastery performance and adaptive expertise in novice diagnostic
reasoning. In Phase I, family medicine residents completed 139 neurology
vignette questions to establish an expert mastery benchmark for diagnostic
accuracy. First- and second-year medical students then completed the same
items to determine the number of cases required to reach mastery. In Phase
II, novices were randomized to either DP or integrated instruction (IN) while
learning four neurology diseases, followed by knowledge acquisition and
application tasks. Participants then participated in a new-learning phase
before completing a second set of tasks to assess their ability to
effectively utilize prior knowledge when learning new information.
RESULTS
Multi-level regression analyses indicated that expert mastery performance
occurred at 75% diagnostic accuracy rate. Novices required 80 ± 5 cases for
at least 71% of learners to achieve this level. In Phase II, no statistically
significant differences were observed between DP and IN groups during initial
learning phase. However, in the new learning phase, the IN group demonstrated
significantly higher diagnostic accuracy in the knowledge application task.
CONCLUSIONS
This study examined how novice learners develop diagnostic reasoning using
DP approach and later compared DP with IN in Phase II. Findings from Phase II
suggested that IN enhanced conceptual understanding of disease mechanisms,
thereby resulting in superior diagnostic performance compared to the DP group
in the new learning phase.
Deliberate practice (DP) is an instructional approach that emphasizes
purposeful repetition of carefully constructed tasks and has been shown to be
effective for developing procedural skills in medical education. However, its
role in fostering more complex aspects of clinical expertise, such as
diagnostic reasoning, remains underexplored. As current healthcare
environment demands clinicians to cultivate adaptive expertise, it is
necessary to determine whether DP supports the development of adaptive
expertise in diagnostic reasoning.
METHODS
A multi-phase experimental study was conducted to determine whether DP
supports mastery performance and adaptive expertise in novice diagnostic
reasoning. In Phase I, family medicine residents completed 139 neurology
vignette questions to establish an expert mastery benchmark for diagnostic
accuracy. First- and second-year medical students then completed the same
items to determine the number of cases required to reach mastery. In Phase
II, novices were randomized to either DP or integrated instruction (IN) while
learning four neurology diseases, followed by knowledge acquisition and
application tasks. Participants then participated in a new-learning phase
before completing a second set of tasks to assess their ability to
effectively utilize prior knowledge when learning new information.
RESULTS
Multi-level regression analyses indicated that expert mastery performance
occurred at 75% diagnostic accuracy rate. Novices required 80 ± 5 cases for
at least 71% of learners to achieve this level. In Phase II, no statistically
significant differences were observed between DP and IN groups during initial
learning phase. However, in the new learning phase, the IN group demonstrated
significantly higher diagnostic accuracy in the knowledge application task.
CONCLUSIONS
This study examined how novice learners develop diagnostic reasoning using
DP approach and later compared DP with IN in Phase II. Findings from Phase II
suggested that IN enhanced conceptual understanding of disease mechanisms,
thereby resulting in superior diagnostic performance compared to the DP group
in the new learning phase.
Presentation Tag(s)
Student Presentation, Best Student Oral Nominee