Some cognitive characteristics of medical students with and without diagnostic reasoning difficulties.
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Biomedical subjects
Publications and source records attributed to G Bordage.
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The value of Patient-Management Problems (PMPs as a learning tool for continuing medical education was studied by using two frequently seen cardiovascular problems (angina and high blood pressure) and a province-wide sample of full-time general practitioners. The results indicate that PMPs can be a motivating and effective means of CME for the general practitioner; that knowledge was gained through the successive resolution of three pmps; that corrective feedback enhanced learning; and, that most of the knowledge gained on the paper cases was transferred to practice as reported by the participants on a questionnaire. Furthermore, while cueing may be a confounding factor when PMPs are used for evaluation purposes, it was shown to facilitate learning in the present learning context.
According to recent research on categorization, knowledge of a given category is structured in memory around key cases or clear examples, referred to as the prototypes, which capture the core meaning of the category. The purpose of this study was to establish a converging sequence of evidence concerning the internal structure of fourteen broad categories of medical disorders as stored in the long-term memories of pre-clinical medical students and experienced doctors. It was shown that the mental representation of the categories was better described by the overlapping features of the prototype view of categorization than the criterial features of the classical view. It is argued that the prototype view may help facilitate the understanding of the learning and problem-solving process in medicine.
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In the Fall of 1982, the "Université Laval" School of Medicine inaugurated a new undergraduate curriculum consisting primarily in the introduction of problem-based learning to foster the development of clinical reasoning. The purpose of the study was to compare the diagnostic performance of the students of the old (n = 118) and the new (n = 120) program. The measurement instrument consisted of 12 short clinical vignettes. There is no significant difference in the performance of the students from the two programs. In spite of these results, it is advocated to wait before initiating yet another curriculum reform or reversal. Finally and for both classes of students, their performance varied significantly from hospital to hospital. A number of suggestions are made to better standardize the quality of clinical teaching across the different hospital settings.