Documentation of Students' Clinical Reasoning Using a Computer Simulation

Schwartz, William Robson

doi:10.1001/archpedi.1989.02150170077026

Cited by 4 publications

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References 5 publications

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“…Interactive video simulations, to the extent that they portray realistic detail about a particular situation with complex, contextual challenges, are capable of fulfilling these conditions for situated cognition (Brown et al, 1989;Rogoff & Lave, 1984). Simulations in the health professions that incorporate interactive video enable the detailed, visual presentation of common clinical diagnoses, make available on a dependable basis the less frequently encountered clinical conditions, and can demonstrate appropriate decision-making approaches to clinical problems (Schwartz, 1989). Over the past 15 years there has been a slow appearance of reports documenting the effects of interactive video experiences among occupational therapy students (Croninger, Tumiel, & Sowa, 1995;Farrow & Sims, 1987;McNurlen, Gilkeson, & Drake, 1996;Tomlin, 1996), but none of the studies included an investigation of the measurement characteristics of the program as a decision-making assessment instrument.…”

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confidence: 99%

The Use of Interactive Video Client Simulation Scores To Predict Clinical Performance of Occupational Therapy Students

Tomlin

2005

The American Journal of Occupational Therapy

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The Use of Interactive Video Client Simulation Scores To Predict Clinical Performance of Occupational Therapy Students

Tomlin

2005

The American Journal of Occupational Therapy

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“…[8] Articles spanning four decades have explored how expert diagnosticians develop their expertise, how they think, and how best to teach diagnostic reasoning [1][2][3][4][9][10][11]15,16,18]. In a recent extensive review of this research, Norman [14] shows how this inquiry has generally shifted from an exploration of general problem-solving strategies, to how and what diagnosticians remember, to mental representations of knowledge.…”

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A Novel Educational Tool for Teaching Diagnostic Reasoning and Laboratory Data Interpretation to Veterinary (and Medical) Students

Bender

Danielson

2011

Clinics in Laboratory Medicine

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The Diagnostic Pathfinder was designed to help students learn diagnostic problem solving by supporting them in explaining relationships among history and physical examination findings, data abnormalities, and the underlying mechanisms of disease. The Pathfinder has been used to teach diagnostic problem solving to veterinary students since 2001 and is currently in use at 10 colleges of veterinary medicine. This article describes how the Pathfinder works and summarizes results from studies exploring the effect of Pathfinder use on learning and satisfaction. Pathfinder characteristics are described in terms of their influence on cognitive load, and strategies are provided for effective implementation.

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The role of strategy and redundancy in diagnostic reasoning

et al. 2003

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BackgroundDiagnostic reasoning is a key competence of physicians. We explored the effects of knowledge, practice and additional clinical information on strategy, redundancy and accuracy of diagnosing a peripheral neurological defect in the hand based on sensory examination.MethodUsing an interactive computer simulation that includes 21 unique cases with seven sensory loss patterns and either concordant, neutral or discordant textual information, 21 3rd year medical students, 21 6th year and 21 senior neurology residents each examined 15 cases over the course of one session. An additional 23 psychology students examined 24 cases over two sessions, 12 cases per session. Subjects also took a seven-item MCQ exam of seven classical patterns presented visually.ResultsKnowledge of sensory patterns and diagnostic accuracy are highly correlated within groups (R2 = 0.64). The total amount of information gathered for incorrect diagnoses is no lower than that for correct diagnoses. Residents require significantly fewer tests than either psychology or 6th year students, who in turn require fewer than the 3rd year students (p < 0.001). The diagnostic accuracy of subjects is affected both by level of training (p < 0.001) and concordance of clinical information (p < 0.001). For discordant cases, refutation testing occurs significantly in 6th year students (p < 0.001) and residents (p < 0.01), but not in psychology or 3rd year students. Conversely, there is a stable 55% excess of confirmatory testing, independent of training or concordance.ConclusionsKnowledge and practice are both important for diagnostic success. For complex diagnostic situations reasoning components employing redundancy seem more essential than those using strategy.

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Documentation of Students' Clinical Reasoning Using a Computer Simulation

Cited by 4 publications

References 5 publications

The Use of Interactive Video Client Simulation Scores To Predict Clinical Performance of Occupational Therapy Students

The Use of Interactive Video Client Simulation Scores To Predict Clinical Performance of Occupational Therapy Students

A Novel Educational Tool for Teaching Diagnostic Reasoning and Laboratory Data Interpretation to Veterinary (and Medical) Students

The role of strategy and redundancy in diagnostic reasoning

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