Propositional versus structural semantic analyses of medical diagnostic thinking

Comparing Apples and Oranges: Some Dangers in Confusing Frameworks with Theories

“…One is that our research, which has subsequently extended this work (Joseph & Patel, 1990;Pate1 and Groen, 1991;Patel, Groen, & Arocha, 1990), has been completely ignored. Another is that, as well be seen, the reason for writing such an article is difficult to ascertain because there is considerable agreement between our results when taken in context with those of Lemieux and Bordage (1992). We will show that despite their claims to the contrary, there is little in the results of Lemieux and Bordage that contradict our results.…”

“…Two articles that recently appeared in the same issue of this journal (Boshuizen & Schmidt, 1982;Lemieux & Bordage, 1992) illustrate two quite different approaches to medical cognition and also embody two quite different approaches to treating previous work in the field. Boshuizen gnd Schmidt (1992) essentially extended an approach initiated by Pate1 and Groen (1986), utilizing more or less the same techniques of propositional analysis.…”

“…Boshuizen gnd Schmidt (1992) essentially extended an approach initiated by Pate1 and Groen (1986), utilizing more or less the same techniques of propositional analysis. Lemieux and Bordage (1992), on the other hand, argued that this approach is misguided and is best replaced by something deeper and more realistic, such as semiotic analysis. We will argue that this claim is grounded on a misunderstanding of the basic nature of the research strategies of cognitive psychology and how the methods and techniques in this area can be applied to educational research.…”

“…A lack of clarity regarding this distinction has tended to result in a grand cognitive framework in which all the psychological aspects of the clinical situation can be covered, and in the position (exemplified not only in the work of Lemieux & Bordage, 1992, but also that of many other medical educators) that only experiments examining this total framework should be taken seriously. However, there are compelling reasons to believe that a cognitive framework and a cognitive theory are inherently quite different, and that an understanding of the relationship between the two is important for applications of psychological research to educational practice.…”

“…The article by Lemieux and Bordage (1992) illustrates some of the dangers of this confusion. It is clear that they are proposing a framework for dealing with knowledge-based clinical reasoning.…”