Loss of experiential training time maybe replaced by the internet
Tang et al[1] discuss the utility of the search engine google to
assist their diagnostic skills in correctly identifying diagnoses of
published cases from a list of three, identified using their own search
terms. This thought provoking study illustrates that physicians may not be
replaced by search engines just yet, with a diagnostic accuracy of only
58%, despite significant bias from two consultant physicians selecting
both the search terms and diagnoses, the latter from a list. Doctors aim
to safely and correctly treat patients, emphasising guarded
interpretation; acting on incorrect guesses maybe more harmful than a
delay in making a correct diagnosis.
Changes to UK postgraduate training promote a greater emphasis on
‘commoner’ symptoms,[2] with devaluation of experience and reduced length
of training replaced by competencies,[3] which may adversely affect
patient safety relating to rarer conditions. Trainees maybe forced to
augment their ‘fit for purpose’ knowledge and substitute their lack
experience with internet content.
Critical evaluation must not be overlooked and anecdotes of correct
patient self-diagnosis comprise the lowest level of evidence in most
hierarchies. At least as many patients may be unable to make a correct
diagnosis. However, once a diagnosis is achieved, google can identify
valuable and relevant content for patients and their carers.[4]
References
[1] Tang H, Ng JHK. Googling for a diagnosis—use of Google as a
diagnostic aid: internet based study. BMJ 2006;333:1143-45.
[2] The Foundation Programme Committee of the Academy of Medical
Royal Colleges, in co-operation with Modernising Medical Careers in
the Departments of Health. Curriculum for the foundation years in
postgraduate education and training. London: DoH, 4 April 2005
[3] Department of Health. Donaldson L. Unfinished business. Proposals
for reform of the Senior House Officer grade. London: DoH, 21 August 2002.
[4] Ellamushi H, Narenthiran G, Kitchen ND. Is current information
available useful for patients and their families? Ann R Coll Surg Engl
2001;83:292-94.
Competing interests:
None declared
Competing interests:
No competing interests
04 December 2006
Amit Patel
Senior House Officer in Cardiology
Heart Hospital, UCLH NHS Foundation Trust, 16-18 Westmoreland Street, London, W1G 8PH, UK
Rapid Response:
Loss of experiential training time maybe replaced by the internet
Tang et al[1] discuss the utility of the search engine google to assist their diagnostic skills in correctly identifying diagnoses of published cases from a list of three, identified using their own search terms. This thought provoking study illustrates that physicians may not be replaced by search engines just yet, with a diagnostic accuracy of only 58%, despite significant bias from two consultant physicians selecting both the search terms and diagnoses, the latter from a list. Doctors aim to safely and correctly treat patients, emphasising guarded interpretation; acting on incorrect guesses maybe more harmful than a delay in making a correct diagnosis.
Changes to UK postgraduate training promote a greater emphasis on ‘commoner’ symptoms,[2] with devaluation of experience and reduced length of training replaced by competencies,[3] which may adversely affect patient safety relating to rarer conditions. Trainees maybe forced to augment their ‘fit for purpose’ knowledge and substitute their lack experience with internet content.
Critical evaluation must not be overlooked and anecdotes of correct patient self-diagnosis comprise the lowest level of evidence in most hierarchies. At least as many patients may be unable to make a correct diagnosis. However, once a diagnosis is achieved, google can identify valuable and relevant content for patients and their carers.[4]
References
[1] Tang H, Ng JHK. Googling for a diagnosis—use of Google as a diagnostic aid: internet based study. BMJ 2006;333:1143-45.
[2] The Foundation Programme Committee of the Academy of Medical Royal Colleges, in co-operation with Modernising Medical Careers in the Departments of Health. Curriculum for the foundation years in postgraduate education and training. London: DoH, 4 April 2005
[3] Department of Health. Donaldson L. Unfinished business. Proposals for reform of the Senior House Officer grade. London: DoH, 21 August 2002.
[4] Ellamushi H, Narenthiran G, Kitchen ND. Is current information available useful for patients and their families? Ann R Coll Surg Engl 2001;83:292-94.
Competing interests: None declared
Competing interests: No competing interests