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The intermediate effect and the diagnostic accuracy in clinical case recall of students and experts in dental medicine


Prof. Dr Jörg Eberhard
Department of Operative Dentistry
Periodontology and Preventive Dentistry
Hannover Medical School
Carl-Neuberg-Str. 1
30625 Hannover, Germany
Tel: +49 511 532 4336
Fax: +49 511 532 4811


Introduction:  The extensive knowledge of experts facilitates the solving of domain-specific problems. In general, this is due to the fact that experts recall more detailed information than do novices or even advanced students. However, if physicians of different expertise levels are asked to write down the details of a given case, advanced medical students recall more information than experts. This phenomenon was called the ‘intermediate effect’ and is considered to be a specific feature of medical expertise. The aim of the here presented study was to examine this observation in the domain of dental medicine.

Materials and methods:  Sixty-one students and 20 specialised dentists participated in this study. Three clinical case descriptions were presented and afterwards the participants were told to write down all concrete information they remembered. Finally, they had to come up with a diagnosis. Interrater agreement, diagnostic accuracy and the recall explanation protocols were analysed statistically in comparison to state-of-the-art (canonical) explanations of the clinical cases.

Results:  The mean interrater agreement was 96.2 ± 3.37%. It was shown statistically that the more experienced the participants, the more accurate their diagnoses were (P < 0.001). The statistical analysis using the Games-Howell test demonstrated significant more written recall of the 5th-year students compared with 3rd- and 4th-year students and experts (P < 0.05).

Conclusion:  The results of this study suggest the existence of the intermediate effect in clinical case recall in dental medicine and thereby corroborate its importance and general applicability for different medical domains.