title: Medical student acquisition of clinical working knowledge.
abstract: BACKGROUND
  Working knowledge of physicians manifests as a combination of diagnostic pattern recognition and clinical data interpretation (analytic fact checking).
  
  
  OBJECTIVE
  The purpose was to study medical student acquisition of these abilities as a function of years of medical training/experience.
  
  
  METHODS
  A cross-sectional study involving students who had completed 0, 1, 2, and 3 years of medical school. All students at all levels of training took the same tests of diagnostic pattern recognition and clinical data interpretation. Percent correct scores were calculated and used to estimate learning curves. A cohort of family physicians also took the test to provide a benchmark.
  
  
  RESULTS
  Student diagnostic pattern recognition and clinical data interpretation ability demonstrated a steady upward growth curve but leveled off in Year 3. Diagnostic pattern recognition performance was consistently higher than clinical data interpretation performance. The rate of diagnostic performance gain with training and experience was also higher.
  
  
  CONCLUSIONS
  Medical students acquired diagnostic pattern recognition ability and all years of medical training contributed. The rate of clinical data interpretation performance improvement was slower, and the absolute performance level was lower. What was surprising was the lower rate of improvement in diagnostic pattern recognition and clinical data interpretation performance for students during their 1st year of clinical training. Students' understanding of findings and their relationships to disease processes may be affected by their limited patient experience.
authors.affiliation: Department of Surgery, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9638, USA. Rwilliams@siumed.edu
authors.forename: Reed G
authors.initials: RG
authors.lastname: Williams
authors.forename: Debra L
authors.initials: DL
authors.lastname: Klamen
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Hoffman
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003430:Cross-Sectional Studies; D003479:Curriculum; D003627:Data Interpretation, Statistical; D004504:Education, Medical, Undergraduate / Q000592:standards*; D004521:Educational Measurement; D004522:Educational Status; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015203:Reproducibility of Results; D012577:Schools, Medical; D013337:Students, Medical; D014481:United States