Clinical Reasoning and Knowledge Organization: Bridging the Gap Between Medical Education and Neurocognitive Science

Longo, Palma J.; Orcutt, Venetia L.; James, Kassidy; Kane, John M.; Coleman, Veronica L

doi:10.1097/jpa.0000000000000224

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…As noted above, the recent history of the USMLE highlights important trends in assessment for licensing in health care provision (e.g., Elstein, 1993; Epstein & Hundert, 2002). We find it particularly salient that other disciplines have relied heavily on strict and comprehensive application of psychological principles and psychometric theory in tackling such challenging questions as the development of optimal and efficient methods for assessing clinical reasoning (Longo, Orcutt, James, Kane, & Coleman, 2018; Rencic, Durning, Holmboe, & Gruppen, 2016) and for ensuring the predictive validity of competency assessment for health care practice (Melnick & Clauser, 2005). It is encouraging and reassuring to see how psychological knowledge and assessment practices have led to substantial improvements in assessment for health care licensure and practice.…”

Section: Discussionmentioning

confidence: 99%

The enhanced examination for professional practice in psychology: A viable approach?

Callahan¹,

Bell²,

Johnson³

et al. 2020

American Psychologist

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Health disciplines have increasingly required competency-based evaluations as a licensure prerequisite. In keeping with this trend, the Association of State and Provincial Psychology Boards (ASPPB) has begun to develop a second part to the Examination for Professional Practice in Psychology (EPPP). The resulting 2-part examination is collectively referred to as the Enhanced EPPP. Part 1 of the Enhanced EPPP, which consists of the current exam, is designed to be an assessment of knowledge. Part 2 of the Enhanced EPPP is newly developed and intended to address the need for a competency-based evaluation. To date, ASPPB has addressed some standard facets of validity for the EPPP Part 2, but not others. In addition, the EPPP Part 2 has yet to be subjected to a broader validation process, in which the suitability of the test for its intended purpose is evaluated. Implementation of the EPPP Part 2 before validation could have negative consequences for those seeking to enter the profession and for the general public (e.g., potential restriction of diversity in the psychology workforce). For jurisdictions implementing the EPPP Part 2, failure to gather and report the evidence required for use of a test in a forensic context may also open the door for legal challenges. We end with suggestions for feasible research that could significantly enhance the validation process for the EPPP Part 2 and offer jurisdictions concrete suggestions of features to look for in determining whether and when to implement the Enhanced EPPP. Public Significance StatementThe national licensing exam for psychologists acts as a gatekeeping evaluation intended to protect public welfare. To date, the suitability and value added of the EPPP Part 2 is unclear, and ASPPB has described only limited plans to conduct validation of the EPPP Part 2. Validation of the planned revision to the exam is of crucial significance to the entire profession and serves to protect the discipline's reputation as a health service provider.

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Section: Discussionmentioning

confidence: 99%

The enhanced examination for professional practice in psychology: A viable approach?

Callahan¹,

Bell²,

Johnson³

et al. 2020

American Psychologist

View full text Add to dashboard Cite

show abstract

“…Moreover, virtual patient simulations (VPSs) in abnormal clinical scenarios may provide an accelerated breakthrough in improving clinical reasoning education [20]. However, there is inadequate evidence of the usefulness of VPSs for improving clinical reasoning skills for undergraduate medical students without lecturer supervision [21,22]. To the best of our knowledge, few studies have used VPSs to comparatively measure which areas of relevant case knowledge and clinical reasoning skills in symptomatology lead to better outcomes.…”

Section: Introductionmentioning

confidence: 99%

The Utility of Virtual Patient Simulations for Clinical Reasoning Education

Watari

Tokuda²,

Owada

et al. 2020

IJERPH

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Virtual Patient Simulations (VPSs) have been cited as a novel learning strategy, but there is little evidence that VPSs yield improvements in clinical reasoning skills and medical knowledge. This study aimed to clarify the effectiveness of VPSs for improving clinical reasoning skills among medical students, and to compare improvements in knowledge or clinical reasoning skills relevant to specific clinical scenarios. We enrolled 210 fourth-year medical students in March 2017 and March 2018 to participate in a real-time pre-post experimental design conducted in a large lecture hall by using a clicker. A VPS program (®Body Interact, Portugal) was implemented for one two-hour class session using the same methodology during both years. A pre–post 20-item multiple-choice questionnaire (10 knowledge and 10 clinical reasoning items) was used to evaluate learning outcomes. A total of 169 students completed the program. Participants showed significant increases in average total post-test scores, both on knowledge items (pre-test: median = 5, mean = 4.78, 95% CI (4.55–5.01); post-test: median = 5, mean = 5.12, 95% CI (4.90–5.43); p-value = 0.003) and clinical reasoning items (pre-test: median = 5, mean = 5.3 95%, CI (4.98–5.58); post-test: median = 8, mean = 7.81, 95% CI (7.57–8.05); p-value < 0.001). Thus, VPS programs could help medical students improve their clinical decision-making skills without lecturer supervision.

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The challenge of clinical reasoning in chronic multimorbidity: time and interactions in the Health Issues Network model

et al. 2023

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The increasing prevalence of multimorbidity requires new theoretical models and educational approaches to develop physicians’ ability to manage multimorbidity patients. The Health Issues Network (HIN) is an educational approach based on a graphical depiction of the evolutions over time of the concurrent health issues of a patient and of their interactions. From a theoretical point of view, the HIN approach is rooted in Prigogine’s vision of the “becoming” of the events and in the concept of knowledge organization, intended as the process of storing and structuring of information in a learner’s mind. The HIN approach allows to design clinical exercises to foster learners’ ability to detect evolutionary paths and interactions among health issues. Recent findings of neuroscience support the expectation that interpreting, completing, and creating diagrams depicting complex clinical cases improves the “sense of time”, as a fundamental competence in the management of multimorbidity. The application of the HIN approach is expected to decrease the risk of errors in the management of multimorbidity patients. The approach is still under validation, both for undergraduate students and for the continuous professional development of physicians.

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Clinical Reasoning and Knowledge Organization: Bridging the Gap Between Medical Education and Neurocognitive Science

Cited by 3 publications

References 6 publications

The enhanced examination for professional practice in psychology: A viable approach?

The enhanced examination for professional practice in psychology: A viable approach?

The Utility of Virtual Patient Simulations for Clinical Reasoning Education

The challenge of clinical reasoning in chronic multimorbidity: time and interactions in the Health Issues Network model

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