A randomized study of iterative hypothesis testing in undergraduate psychiatric education: Brief communication

Objective: Iterative hypothesis testing (IHT) or related strategies of diagnostic decision making have been taught in many curricula for medical students but not in psychiatry. We therefore asked whether the addition of training in IHT may add to the quality of the psychiatry course. Method: Seventy-two medical students were randomized to four weeks problem-based learning or to IHT. Knowledge and skills of the students were tested using a multiple choice exam and simulated patients. Results: Iterative hypothesis testing-trained students recognized more diagnostic items and more often identified comorbid psychiatric disorders and acute suicidal tendencies. Acquisition of general psychiatric knowledge and global satisfaction with the course were similar in both groups. Conclusion: We conclude that teaching IHT to medical students may enhance their clinical ability to recognize complex disease patterns. Further studies are required concerning the enhancement of clinical skills in the psychiatric specialty.