Learning How to Build Illness Scripts

Gavinski, Katherine; Covin, Yvonne N.; Longo, Palma J.

doi:10.1097/acm.0000000000002493

Cited by 10 publications

(5 citation statements)

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“…Illness scripts are "mental cue cards" consisting of key features of individual diseases. 27 These mental representations are crucial for future problem-solving. Structured reflection has the potential to improve students' diagnostic competency by encouraging students to compare different illness scripts in a clinical encounter.…”

Section: Teaching Methods Useful In the Clinical Settingmentioning

confidence: 99%

“…8,47 Key features of an illness script include epidemiological factors, signs and symptoms of a disease, as well as the pathophysiology behind it. 27 Lee et al 13 conducted a workshop teaching students the important elements of CR, problem representation, and how to develop and select an appropriate illness script. Diagnostic performance was assessed by objectively using 10 CR problems (CRP) and subjectively using the diagnostic thinking inventory (DTI).…”

Section: Recordsmentioning

confidence: 99%

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Methods to Improve Diagnostic Reasoning in Undergraduate Medical Education in the Clinical Setting: a Systematic Review

Ang

Soh

et al. 2021

J GEN INTERN MED

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BACKGROUND: In recent years, there have been numerous studies exploring different teaching methods for improving diagnostic reasoning in undergraduate medical students. This systematic review examines and summarizes the evidence for the effectiveness of these teaching methods during clinical training. METHODS: PubMed, Embase, Scopus, and ERIC were searched. The inclusion criteria for the review consist of articles describing (1) methods to enhance diagnostic reasoning, (2) in a clinical setting (3) on medical students. Articles describing original research using qualitative, quantitative, or mixed study designs and published within the last 10 years (1 April 2009-2019) were included. Results were screened and evaluated for eligibility. Relevant data were then extracted from the studies that met the inclusion criteria. RESULTS: Sixty-seven full-text articles were first identified. Seventeen articles were included in this review. There were 13 randomized controlled studies and four quasiexperimental studies. Of the randomized controlled studies, six discussed structured reflection, four self-explanation, and three prompts for generating differential diagnoses. Of the remaining four studies, two employed the SNAPPS 1 technique for case presentation. Two other studies explored schema-based instruction and using illness scripts. Twelve out of 17 studies reported improvement in clinical reasoning after the intervention. All studies ranked level two on the New World Kirkpatrick model. DISCUSSION: The authors posit a framework to teach diagnostic reasoning in the clinical setting. The framework targets specific deficiencies in the students' reasoning process. There remains a lack of studies comparing the effectiveness of different methods. More comparative studies with standardized assessment and evaluation of longterm effectiveness of these methods are recommended.

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Section: Teaching Methods Useful In the Clinical Settingmentioning

confidence: 99%

Section: Recordsmentioning

confidence: 99%

Methods to Improve Diagnostic Reasoning in Undergraduate Medical Education in the Clinical Setting: a Systematic Review

Ang

Soh

et al. 2021

J GEN INTERN MED

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“…Explicit agenda setting, transparent clinician intent, and sample scripts can save time. 64,90,91 The CCMS may make clinical encounters more efficient and effective by structuring the assessment of the complex experience of suffering. Helping patients address the sources of their suffering may also reduce unnecessary tests and consultations.…”

Section: Limitationsmentioning

confidence: 99%

A Comprehensive Clinical Model of Suffering

2023

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Suffering is often a part of the illness experience, and relieving it is a fundamental obligation of medicine. Distress, injury, disease, and loss generate suffering when they threaten meaning in the patient's personal narrative. Family physicians have exceptional opportunities and responsibilities to manage suffering through long-term continuity relationships, demonstrating empathy, and building trust over time and across problems. We propose a new Comprehensive Clinical Model of Suffering (CCMS) founded on the family medicine approach to whole-patient care. Comprehending that suffering can involve every aspect of a patient's life, the CCMS is constructed on 4 axes and 8 domains that form a "Review of Suffering" to help clinicians recognize and manage patient suffering. Applied to clinical care, the CCMS can guide observation and empathetic questioning. Applied to teaching, it can provide a framework for discussions of complex and challenging patients. Barriers to applying the CCMS in practice include clinician training, time with patients, and competing demands. However, by structuring the clinical assessment of suffering, the CCMS may increase the efficiency and effectiveness of clinical encounters and improve patient care and outcomes. The application of the CCMS to patient care, clinical training, and research will require further evaluation.

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“…LTM has theoretically an infinite capacity and has no limitations in terms of duration and volume of information that it can store (Witt et al, 2019). However, like any well-managed library, LTM entitles a network of classification and categorization of information built of meaningful connections and route maps of cognitive strategies called schemas (in the context of medical education referred to as illness scripts, Custers, 2015;Whitehead et al, 2016;Gavinski et al, 2019). Cognitive schemas are prototypes of learning and problem-solving strategies that are created and refined over the course of ontological learning history (Disner et al, 2011;Bartels et al, 2017;McArthur et al, 2019).…”

Section: Cognitive Load Theorymentioning

confidence: 99%

Academic Management in Uncertain Times: Shifting and Expanding the Focus of Cognitive Load Theory During COVID-19 Pandemic Education

Gould

Sawarynski²,

Mohiyeddini³

2022

Front. Psychol.

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Globally, the COVID-19 pandemic has forced medical education toward more “online education” approaches, causing specific implications to arise for medical educators and learners. Considering an unprecedented and highly threatening, constrained, and confusing social and educational environment caused by the COVID-19 pandemic, we decided to shift the traditional focus of the Cognitive Load Theory (CLT) from students to instructors. In this process, we considered recent suggestions to acknowledge the psychological environment in which learning happens. According to this fundamental fact, “Learning and instructional procedures do not occur in a situational vacuum.” Following this assertion, we adapted and implemented principles of CLT to reduce the extraneous load for our faculty to facilitate continued scholarly activity and support the overall wellbeing of our faculty during these trying times. The adoption of these principles enabled our team to cultivate attitudes and skills across multiple domains, such as online presentation technologies, implementing and maintaining a “classroom atmosphere” in a virtual environment, encouraging discussion among large online groups of students, facilitating group work, providing virtual office hours, and proactively planning for subsequent sessions.

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Learning How to Build Illness Scripts

Cited by 10 publications

References 0 publications

Methods to Improve Diagnostic Reasoning in Undergraduate Medical Education in the Clinical Setting: a Systematic Review

Methods to Improve Diagnostic Reasoning in Undergraduate Medical Education in the Clinical Setting: a Systematic Review

A Comprehensive Clinical Model of Suffering

Academic Management in Uncertain Times: Shifting and Expanding the Focus of Cognitive Load Theory During COVID-19 Pandemic Education

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