Achieving equal standards in medical student education: is a national exit examination the answer?
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Biomedical subjects
Publications and source records attributed to Ken Cox.
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BACKGROUND: This paper demystifies clinical perception by explaining its mechanisms, using insights from neuroscience and evolutionary biology. Clinical diagnosis begins with rapid recognition using our imaging, perceptual (but non-verbal) brain, followed by guided search using our slower, verbal, reasoning brain. Experiential cognition can be (more or less) achieved by integrating these two ways of knowing. Perceptual expertise requires alertness and persistence to ensure clinical accuracy. Each clinician, as a self-aware participant-observer (SAPO) keeping track of what they're thinking 'as it happens', can study their perceptual accuracy, pattern matching, interpretation, motivation and judgement.
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Clinical practice is not always user-friendly. Specialisation fragments patient care across different investigations and modes of management. Increasing hospital throughput, especially by day surgery, diminishes the time available for students and other health professionals in the team to interact with the patient and verify the appropriateness of the care plan. Patients are at a serious disadvantage in ensuring that their concerns are understood, and in negotiation of which management plan would optimise the outcomes they seek.
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