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Complexities of perceived and actual performance in pathology interpretation: A comparison of cutaneous melanocytic skin and breast interpretations
Author(s) -
Carney Patricia A.,
Frederick Paul D.,
Reisch Lisa M.,
Titus Linda,
Knezevich Stevan R.,
Weinstock Martin A.,
Piepkorn Michael W.,
Barnhill Raymond L.,
Elder David E.,
Weaver Donald L.,
Elmore Joann G.
Publication year - 2018
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/cup.13147
Subject(s) - medicine , medical diagnosis , confidence interval , psychological intervention , comprehension , intervention (counseling) , dermatology , pathology , linguistics , philosophy , psychiatry
Background Little is known about how pathologists process differences between actual and perceived interpretations. Objective To compare perceived and actual diagnostic agreement before and after educational interventions. Methods Pathologists interpreted test sets of skin and/or breast specimens that included benign, atypical, in situ and invasive lesions. Interventions involved self‐directed learning, one skin and one breast, that showed pathologists how their interpretations compared to a reference diagnoses. Prior to the educational intervention, participants estimated how their interpretations would compare to the reference diagnoses. After the intervention, participants estimated their overall agreement with the reference diagnoses. Perceived and actual agreements were compared. Results For pathologists interpreting skin, mean actual agreement was 52.4% and overall pre‐ and postinterventional mean perceived agreement was 72.9% vs 54.2%, an overestimated mean difference of 20.5% (95% confidence interval [CI] 17.2% to 24.0%) and 1.8% (95% CI −0.5% to 4.1%), respectively. For pathologists interpreting breast, mean actual agreement was 75.9% and overall pre‐ and postinterventional mean perceived agreement was 81.4% vs 76.9%, an overestimation of 5.5% (95% CI 3.0% to 8.0%) and 1.0% (95% CI 0.0% to 2.0%), respectively. Conclusions Pathologists interpreting breast tissue had improved comprehension of their performance after the intervention compared to pathologists interpreting skin lesions.