Background: One of the most discriminating measures of expertise in multiple domains has been performance on memory tasks. In medicine, however, the relation between expertise and memory is more equivocal.
Purpose: To compare and contrast the sufficiency of multiple explanations of this finding by using three probes of memory rather than the traditional free recall task alone.
Methods: Students, residents, and internists were asked to read case histories and assign diagnoses before undertaking free recall, cued recall, and recognition tests.
Results: Students consistently outperformed internists. Resident performance was more variable.
Conclusions: Our data appear to rule out (a) the notion that expert memory for cases takes on an encapsulated form, (b) the idea that experts simply say less than students in response to a free recall task, and (c) the possibility that experts attend differentially to highly diagnostic features. The results can best be explained by the idea that students process the featural details of a case history more elaborately than do expert diagnosticians who, instead, read medical cases more holistically.