Denise M. Assunção, Alexandre S. Moura, Lígia M. C. Ribeiro


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.


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dermatology; learning; analogy; medical education

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