Error as a pedagogical tool in the development of diagnostic reasoning in Medical students

Abstract

Introduction: The development of diagnostic reasoning is an essential competency in medical training. Traditionally, clinical error has been viewed as a failure to be avoided, overlooking its pedagogical potential to promote reflective learning and patient safety. Materials and methods: A quantitative approach with a quasi-experimental design was used, comparing a control group (traditional method) and an experimental group (error-based learning) using pre-test and post-test measurements. The sample included medical students in clinical training. The intervention consisted of a structured didactic protocol in phases: error identification, causal analysis, guided discussion, technical correction, and transfer of learning. Results: Both groups were homogeneous at baseline (p>0.05). After the intervention, the experimental group showed significantly greater improvements in diagnostic reasoning (p<0.001; d=2.71), with a large effect size (d>2). A 50–60% reduction in error recurrence was observed. The greatest improvements were observed in the formulation of diagnostic hypotheses and clinical interpretation. The Error-Based Clinical Learning Didactic Model (MD-ACE) was designed and validated using the IADOV technique, achieving a satisfaction index of 0.96. Discussion: These findings align with previous studies highlighting the value of structured debriefing, causal analysis, and guided reflection in strengthening clinical reasoning and metacognition. Conclusions: Error-based learning is an effective pedagogical strategy for promoting reflective learning, improving clinical decision-making, and strengthening a culture of patient safety in medical education.