Abstract:
OBJECTIVE:This paper aims to summarise the evidence supporting the role of experience-based, non-analytic reasoning (NAR) or pattern recognition as a central feature of expert medical diagnosis. METHODS:The authors examine a series of studies, primarily from their own research programme at McMaster University, that demonstrate that expert and novice diagnostic problem solving is based, to some degree, on similarity to a prior specific exemplar in the memory. RESULTS:The studies reviewed have shown NAR to be a component of diagnostic reasoning at all levels from novice to subspecialist, and in dermatology, electrocardiography and psychiatry. The retrieval process is rapid and is not available to retrospect. It may be based on visual similarity, but can also be present in verbal descriptions. Some evidence exists that the process is unlikely to be available to introspection. Further, early hypotheses based on NAR can result in the re-interpretation of critical clinical findings. CONCLUSIONS:Non-analytic reasoning is a central component of diagnostic expertise at all levels. Clinical teaching should recognise the centrality of this process, and aim to both enhance the process through the learning of multiple examples and to supplement the process with analytical de-biasing strategies.
journal_name
Med Educjournal_title
Medical educationauthors
Norman G,Young M,Brooks Ldoi
10.1111/j.1365-2923.2007.02914.xsubject
Has Abstractpub_date
2007-12-01 00:00:00pages
1140-5issue
12eissn
0308-0110issn
1365-2923pii
MED2914journal_volume
41pub_type
杂志文章,评审abstract::Recent graduates (1989-1990) of a traditional school of Chinese medicine were assessed by observers using a 10-item scale for professional behaviour in the non-cognitive realm. Overall, 10.7% of the graduates had low ratings on this scale. Of those who scored in the top two quartiles on this scale, 71.4% reported that...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1994.tb02715.x
更新日期:1994-07-01 00:00:00
abstract:CONTEXT:Prior studies suggest that clinicians can categorise patients in an emergency room as 'sick' or 'not sick' using rapid visual assessment. The rapid nature of these decisions suggests clinicians are relying on pattern recognition or System 1 processing; however, this has not been studied experimentally. In this ...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/medu.13396
更新日期:2017-11-01 00:00:00
abstract:INTRODUCTION:Reflective ability is an important skill for enhancing professionalism and developing communication skills. To improve reflective ability, medical educators encourage use of written reflective journals, for which feedback is important. It is difficult for educators to anticipate how their feedback will be ...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/medu.14406
更新日期:2020-11-03 00:00:00
abstract::The work of five principals in a teaching general practice was audited to examine differences in prescribing, investigation and follow-up between teaching and service work over a 3-week period. The patients seen in clinical teaching were found to be representative of those consulting in normal service sessions for bot...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1981.tb02407.x
更新日期:1981-03-01 00:00:00
abstract:CONTEXT:Resources for medical education are becoming more constrained, whereas accountability in medical education is increasing. In this constrictive environment, medical schools need to consider and justify their selection procedures in terms of costs and benefits. To date, there have been no studies focusing on this...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/medu.13698
更新日期:2018-12-01 00:00:00
abstract::The skill of inquiry is central to the task of the doctor confronted with a patient problem. Despite its importance this skill is not given appropriate emphasis in the education of medical students or in research concerning the clinical reasoning skills of doctors. ...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1990.tb02428.x
更新日期:1990-01-01 00:00:00
abstract:CONTEXT:The banner of patient-centredness flies over many academic institutions; however, the practice and teaching of medicine remain oriented to disease. This incongruence is the result of an original Flexnerian dichotomy between the basic and clinical sciences and is maintained by a more recent distinction between d...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.2007.02905.x
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to gather information regarding the appropriateness of the length of time allotted for candidates to complete the history taking and physical examination tasks in a high-stakes standardized patient (SP) assessment. DESIGN:Data were collected on actual time used by 1548 examinee...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1046/j.1365-2923.2000.00752.x
更新日期:2000-10-01 00:00:00
abstract:CONTEXT:Complete reporting of research is essential to enable consumers to accurately appraise, interpret and apply findings. Quality appraisal checklists are giving way to tools that judge the risk for bias. OBJECTIVES:We sought to determine the prevalence of these complementary aspects of research reports (completen...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/medu.13130
更新日期:2017-01-01 00:00:00
abstract:CONTEXT:Although work-based assessments (WBA) may come closest to assessing habitual performance, their use for summative purposes is not undisputed. Most criticism of WBA stems from approaches to validity consistent with the quantitative psychometric framework. However, there is increasing research evidence that indic...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/medu.12289
更新日期:2013-12-01 00:00:00
abstract::A postal survey about opinions of quality assurance and the methods used to teach this subject was sent to all family practice course organizers in England, Wales and Scotland, and to all family practice residency directors in the USA. Opinions of quality assurance were more positive from the American responders. A wi...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1990.tb00010.x
更新日期:1990-05-01 00:00:00
abstract:CONTEXT AND OBJECTIVE:In many countries, medical training must be completed by presentation of a thesis. We report publication patterns of French medical theses. MATERIALS:We drew a random sample of theses presented in the 36 French medical universities between 1 January 1993 and 31 December 1997. The sample was strat...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1046/j.1365-2923.2001.00768.x
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVES:This study aimed to describe the application, feasibility and outcomes of using simulated patients (SPs) to increase the skills of general practitioners (GPs) delivering a behavioural intervention to reduce childhood overweight and mild obesity. METHODS:Five female actors were trained as SPs. A total of 67 ...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.2010.03686.x
更新日期:2010-07-01 00:00:00
abstract:CONTEXT:Effective communication skills are at the core of good health care. Simulated patients (SPs) are increasingly engaged as an interactive means of teaching, applying and practising communication skills with immediate feedback. There is a large body of research into the use of manikin-based simulation but a gap ex...
journal_title:Medical education
pub_type: 杂志文章,评审
doi:10.1111/medu.13387
更新日期:2017-12-01 00:00:00
abstract::An improved teaching package is described which aims to help general practice trainees manage somatized presentations of psychological distress. The package comprises a training videotape in which a reattribution model is demonstrated, with material for role-play of new skills and small-group video feedback of consult...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1992.tb00139.x
更新日期:1992-03-01 00:00:00
abstract:OBJECTIVES:Since their introduction, workplace-based assessments (WBAs) have proliferated throughout postgraduate medical education. Previous reviews have identified mixed findings regarding WBAs' effectiveness, but have not considered the importance of user-tool-context interactions. The present review was conducted t...
journal_title:Medical education
pub_type: 杂志文章,评审
doi:10.1111/medu.14221
更新日期:2020-11-01 00:00:00
abstract::The aims of this study were to gain an understanding of the concerns of those in control in Canadian Family Medicine, and to gain an understanding of the experiences of trainees in the traditional postgraduate year 2 (PGY-2) and in a flexible PGY-2 at the University of Toronto (U of T) Department of Family and Communi...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1996.tb00852.x
更新日期:1996-09-01 00:00:00
abstract:CONTEXT:Trainees in undergraduate and postgraduate medical education engage in multiple transitions as part of the educational process, including many transitions that occur on both periodic and daily bases within medical education programmes. The clinical rotation, based on either a medical discipline or clinical care...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.2010.03847.x
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:To examine how patient-centredness is understood and enacted in an American (US) and an Italian group of health care professionals. METHODS:An action research methodology was used. Two interprofessional groups of US (n = 4) and Italian (n = 5) health care professionals independently wrote a patient-centred d...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.2008.03038.x
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVES:To establish teaching objectives, methods and assessment for a paediatric induction programme. DESIGN:Action research over a 2-year period. PARTICIPANTS:88 doctors from three hospitals. MAIN OUTCOME MEASURES:These were end-of-course evaluations, using Likert scales, and free comments; independent evaluati...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1046/j.1365-2923.2001.00982.x
更新日期:2001-08-01 00:00:00
abstract:AIM:The aim of the study was to explore the different ways in which doctors have learned to teach and train. INTRODUCTION:There is no coherent theory of medical teacher development. Doctors are experts in what they teach; most have had little or no training in how they teach. Research has mostly concentrated on the ac...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2929.2005.02335.x
更新日期:2005-12-01 00:00:00
abstract:CONTEXT:Interprofessional education (IPE) aspires to enable collaborative practice. Current IPE offerings, although rapidly proliferating, lack evidence of efficacy and theoretical grounding. OBJECTIVES:Our research aimed to explore the historical emergence of the field of IPE and to analyse the positioning of this ac...
journal_title:Medical education
pub_type: 历史文章,杂志文章
doi:10.1111/medu.12668
更新日期:2015-04-01 00:00:00
abstract::In 1979, the College of Medicine, Lagos, Nigeria embarked on a new curriculum, which places more emphasis on primary health care in line with the needs of the country. This paper discusses one aspect of the primary health care course, family planning, which involves teaching a practical subject to a large number of st...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1986.tb01040.x
更新日期:1986-01-01 00:00:00
abstract::Beginning medical students spend numerous hours every week attending basic science lectures and taking notes. Medical faculty often wonder whether they should give students pre-printed instructors' notes before lectures. Proponents of this strategy argue that provided notes enhance learning by facilitating the accurat...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1046/j.1365-2923.2002.01167.x
更新日期:2002-04-01 00:00:00
abstract::Associations between language background, English language proficiency and medical communication skills were investigated in a group of 149 third year undergraduate medical students studying at an Australian university. Written and aural English proficiency were assessed with the Screening Test for Adolescent Language...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1997.tb02922.x
更新日期:1997-07-01 00:00:00
abstract::How contract learning may be used in the introduction to clinical medicine is described, with the goal to develop and enhance self-directed learning skills and attitudes of first- and second-year medical students. Essential tasks associated with successful self-directed learning are cited, and the contract method is d...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1983.tb01458.x
更新日期:1983-07-01 00:00:00
abstract::By providing injecting equipment to drug misusers, community pharmacists in the UK may become involved in preventing the spread of HIV via the intravenous route. Over 60% of pharmacy graduates from the School of Pharmacy enter community pharmacy and, as part of their undergraduate course, attend a series of lectures a...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1994.tb02725.x
更新日期:1994-11-01 00:00:00
abstract:AIMS:This paper describes the process of validating the Readiness for Interprofessional Learning Scale (RIPLS) for use with postgraduate health care professionals. CONTEXT:The RIPLS questionnaire has proved useful in the undergraduate context, enabling tutors to assess the readiness of students to engage in interprofe...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2929.2006.02442.x
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVES:(i) To design a new, quick and efficient method of assessing specific cognitive aspects of trainee clinical communication skills, to be known as the Objective Structured Video Exam (OSVE) (Study 1); (ii) to prepare a scoring scheme for markers (Study 2); and (iii) to determine reliability and evidence for va...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1046/j.1365-2923.2000.00792.x
更新日期:2000-11-01 00:00:00
abstract:CONTEXT:About 40% of British General Practitioners (GPs) train formally in a psychiatric post as part of their general practice training, but such training may not fully meet the needs of future GPs. A specific course in psychiatry for family doctors has run in Manchester for more than a decade. METHOD:Semi-structured...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1046/j.1365-2923.1999.00343.x
更新日期:1999-06-01 00:00:00