Efeito da elaboração de mapas conceituais baseados na fisiopatologia sobre a acurácia diagnóstica de estudantes de medicina

Abstract

Introduction: The effect of the use of the concept map on the promotion of significant learning has already been well evaluated, but its impact on the development of clinical reasoning is not well known yet. Objective: To evaluate the impact of the formulation of conceptmaps on the diagnosis accuracy of medical students. Methodology: Experimental assessment of students on the 6th (six) semester of the Medical School of the Jose do Rosario Vellano University - UNIFENAS. 46 students were divided into two groups: concept map (GM) (n = 24) and control group (CG) (n = 22). The assessment was carried out in two stages: training and evaluation. During the training stage, the students solved 6 clinical cases, corresponding to two clinical syndromes (jaundice and chest pain) and were initially allowed one and a half minute to read the case and write the most likely diagnosis. Thereafter, students of the GM group were instructed to formulate a concept map and indicate the final diagnosis and two differential diagnoses. Instead of working on a concept map, students on the CG were instructed to engage in a distracting task. The evaluation stage was carried out a week later, and the participants provided diagnoses for other eight clinical cases, with no specific orientations. Results: There was a significant reduction on the performance of the students comparing step 2 (evaluation) and step 1 (training) (p = 0.032) and no significant statistical association was found between the use of concept maps and students' performance in neither of the two stages (p = 0.577).In the analysis stratified by clinical syndrome, a statistically significant difference between the students' performance in each clinical syndrome was observed (p < 0.001), with a decrease in diagnosis accuracy in the cases of chest pain, whilst the performance for the cases of jaundice do not show a significant difference between the training and the evaluation stages. This observed pattern does not differ between the GM group and the control group (p = 0.467). Conclusion: The formulation of a concept map guided towards pathophysiology mechanisms has not improved the diagnosis accuracy of medical students. Further studies are needed to clarify the influence and the format of use of concept maps guided towards pathophysiology mechanisms of diseases on the improvement of clinical reasoning.