Functional neuroimaging correlates of thinking flexibility and knowledge structure in memory: Exploring the relationships between clinical reasoning and diagnostic thinking

Durning, Steven J.; Costanzo, Michelle E.; Beckman, Thomas J.; Artino, Anthony R.; Roy, Michael J.; Vleuten, Cees van der; Holmboe, Eric S.; Lipner, Rebecca S.; Schuwirth, Lambert

doi:10.3109/0142159x.2015.1047755

Cited by 22 publications

(15 citation statements)

References 45 publications

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“…Moreover, Durning et al . added additional validity to the DTI measurements through neuroimaging correlates, providing more evidence to prove that questionnaire responses reflect to diagnostic thinking patterns . Last but not least, one must consider the learning styles as students approach learning differently.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, Durning et al added additional validity to the DTI measurements through neuroimaging correlates, providing more evidence to prove that questionnaire responses reflect to diagnostic thinking patterns. 27 Last but not least, one must consider the learning styles as students approach learning differently. The suggestion therefore is that different learner types respond either more positively or negatively towards VP contents, which also impacts their knowledge gain.…”

Section: Study Limitationsmentioning

confidence: 99%

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Problem‐based learning in internal medicine: virtual patients or paper‐based problems?

Sobočan

Turk

Dinevski

et al. 2017

Internal Medicine Journal

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Section: Discussionmentioning

confidence: 99%

Section: Study Limitationsmentioning

confidence: 99%

Problem‐based learning in internal medicine: virtual patients or paper‐based problems?

Sobočan

Turk

Dinevski

et al. 2017

Internal Medicine Journal

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“…Expertise is then developed by deliberate practice with multiple specific examples representing the underlying pattern (23). Conscious or subconscious pattern recognition, a form of nonanalytical thinking, is recognized as an important component of clinical reasoning (24)(25)(26)(27)(28)(29) and is therefore a skill we should aim to develop in our students. Pattern recognition also plays a key role in transfer of learning, which is the ability to apply what was learned in one context to new contexts (21,23,30,31).…”

Section: Introductionmentioning

confidence: 99%

Core concepts in physiology: teaching homeostasis through pattern recognition

Chirillo

Silverthorn

Vujović

2021

Advances in Physiology Education

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Homeostasis is a core concept in systems physiology that future clinicians and biomedical professionals will apply in their careers. Despite this, many students struggle to transfer the principles governing homeostasis to concrete examples. Precourse assessments conducted on 72 undergraduate biology students enrolled in an introductory systems physiology course at the University of Belgrade during the February–May semester of 2021 revealed that students had a vague, fragmentary understanding of homeostasis and its related concepts that was often conflated with topics touched on during their previous coursework. We formalized and implemented an approach to teaching homeostasis that focused heavily on consistent reinforcement of physiological reflex patterns throughout the course. To that end, we employed a variety of activities aimed at getting students to view organ system integration holistically. After the semester, postcourse assessment demonstrated that students were better able to provide concrete examples of organ system contributions to homeostasis and were more adept at applying basic principles to novel physiological scenarios. Comparison of final grades with previous semesters revealed that students outperformed their peers who had taken the course previously. In this article, we summarize the findings of pre- and postcourse assessments, describe the general approach we took to teaching homeostasis as well as the specific techniques used in the classroom, and compare student performance with previous semesters.

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“…25 These may be reasons why initial attempts in the domain of medicine to differentiate between system 1 and system 2 were met with limited success. 26 A typical observation in these studies is that there is similar brain activity for written cases that were designed to elicit system-1 thinking and cases that were designed to elicit system-2 thinking (e.g. cases in which important diagnostic information was omitted, and thus, more brain activity was to be expected in the prefrontal cortex area).…”

Section: Introductionmentioning

confidence: 99%

Evidence supporting dual‐process theory of medical diagnosis: a functional near‐infrared spectroscopy study

et al. 2018

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Purpose The objective of this study was to determine the extent to which the dual‐process theory of medical diagnosis enjoys neuroscientific support. To that end, the study explored whether neurological correlates of system‐2 thinking could be located in the brain. It was hypothesised that system‐2 thinking could be observed as the activation of the prefrontal cortex. Method An experimental paradigm was applied that consisted of a learning and a test phase. During the learning phase, 22 medical students were trained in diagnosing chest X‐rays. Four of these eight cases were presented repeatedly, to develop a high level of expertise for these cases. During the test phase, all eight cases were presented and the participants’ prefrontal cortex was scanned using functional near‐infrared spectroscopy. Response time and diagnostic accuracy were recorded as behavioural indicators. Results The results revealed that participants’ diagnostic accuracy in the test phase was significantly higher for the trained cases as compared with the untrained cases (F[1, 21] = 138.80, p < 0.001, η2 = 0.87). Also, their response time was significantly shorter for these cases (F[1, 21] = 18.12, p < 0.001, η2 = 0.46). Finally, the results revealed that only for the untrained cases, could a significant activation of the anterolateral prefrontal cortex be observed (F[1, 21] = 21.00, p < 0.01, η2 = 0.34). Conclusion The fact that only untrained cases triggered higher levels of blood oxygenation in the prefrontal cortex is an indication that system‐2 thinking is a cognitive process distinct from system 1. Implications of these findings for the validity of the dual‐process theory are discussed.

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Functional neuroimaging correlates of thinking flexibility and knowledge structure in memory: Exploring the relationships between clinical reasoning and diagnostic thinking

Cited by 22 publications

References 45 publications

Problem‐based learning in internal medicine: virtual patients or paper‐based problems?

Problem‐based learning in internal medicine: virtual patients or paper‐based problems?

Core concepts in physiology: teaching homeostasis through pattern recognition

Evidence supporting dual‐process theory of medical diagnosis: a functional near‐infrared spectroscopy study

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