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PubMed1989

If dancers ate their shoes: inductive reasoning with factual and counterfactual premises.

This experiment addressed the effect of precue information, which may be either familiar or novel, and either relevant or irrelevant, on the solution of inductive reasoning problems. Sixty undergraduate students each completed 216 verbal inductive reasoning problems and five psychometric ability tests. The reasoning problems were equally divided among analogies, classifications, and series completions, with half of each kind of item presented in a standard, uncued format, and half presented with a precue. With respect to internal validation, it was found that for analogies and classifications, subjects take longer to process irrelevant than relevant information if the precue is familiar, but they take longer to process relevant than irrelevant information if the precue is novel. For series completions, this relation does not hold; rather, both novelty and irrelevance add time to the processing of information, with the time for irrelevance greater than that for novelty. The utility of precues for different tasks was explored, and it was found that familiar relevant precues facilitated solution of the more difficult kinds of items (classifications and series completions), but hampered solution of the easier, more automatically solved items (analogies). With respect to external validation, it was found that the nonentrenched induction tasks overlapped with psychometric tests in terms of abilities measured, that the abilities measured were fluid rather than crystallized, and that the precued (more nonentrenched) items were better measures of fluid abilities than were the uncued items.

Adult↗
PubMed1994

Interpretational factors in conditional reasoning.

Two experiments examined the role of necessity and sufficiency relationships in conditional reasoning. The results indicated that perceived necessity and sufficiency predicted variability in reasoning performance for four pragmatic relations (permission, obligation, causation, and definition), for both determinant and indeterminant syntactic forms, and for both a conditional arguments and a truth table evaluation task, as well as when the temporal relationship between the antecedent and consequent events was reversed. These data support the general utility of perceived necessity and sufficiency in the interpretation and evaluation of conditional relationships. However, the effects of necessity and sufficiency were smaller for reversed than for forward statements, which suggests that necessity/sufficiency-based interpretations may be more useful for evaluating some types of conditional relations than others. In addition, people were more likely to accept valid rather than invalid arguments, regardless of necessity/sufficiency relations, a finding that suggests that abstract, content-free representations may play a functional role in conditional reasoning.

Cognition↗
PubMed2000

Reasoning versus text processing in the Wason selection task: a nondeontic perspective on perspective effects.

We argue that perspective effects in the Wason four-card selection task are a product of the linguistic interpretation of the rule in the context of the problem text and not of the reasoning process underlying card selection. In three experiments, participants recalled the rule they used in either a selection or a plausibility rating task. The results showed that (1) participants tended to recall rules compatible with their card selection and not with the rule as stated in the problem and (2) recall was not affected by whether or not participants performed card selection. We conclude that perspective effects in the Wason selection task do not concern how card selection is reasoned about but instead reflect the inferential text processing involved in the comprehension of the problem text. Together with earlier research that showed selection performance in nondeontic contexts to be indistinguishable from selection performance in deontic contexts (Almor & Sloman, 1996; Sperber, Cara, & Girotto, 1995), the present results undermine the claim that reasoning in a deontic context elicits specialized cognitive processes.

Attention↗
PubMed1999

Falsifying mental models: testing the predictions of theories of syllogistic reasoning.

Four experiments are reported that tested the claim, drawn from mental models theory, that reasoners attempt to construct alternative representations of problems that might falsify preliminary conclusions they have drawn. In Experiment 1, participants were asked to indicate which alternative conclusion(s) they had considered in a syllogistic reasoning task. In Experiments 2-4, participants were asked to draw diagrams consistent with the premises, on the assumption that these diagrams would provide insights into the mental representation being used. In none of the experiments was there any evidence that people constructed more models for multiple-model than for single-model syllogisms, nor was there any correlation between number of models constructed and overall accuracy. The results are interpreted as showing that falsification of the kind proposed by mental models theory may not routinely occur in reasoning.

Humans↗
PubMed1999

Deductive reasoning with factual, possible, and counterfactual conditionals.

We compared reasoners' inferences from conditionals based on possibilities in the present or the past (e.g., "If Linda had been in Dublin then Cathy would have been in Galway") with their inferences based on facts in the present or the past (e.g., "If Linda was in Dublin then Cathy was in Galway"). We propose that people construct a richer representation of conditionals that deal with possibilities rather than facts: Their models make explicit not only the suppositional case, in which Linda is in Dublin and Cathy is in Galway, but also the presupposed case, in which Linda is not in Dublin and Cathy is not in Galway. We report the results of four experiments that corroborate this model theory. The experiments show that reasoners make more inferences from conditionals based on possibilities rather than on facts when the inferences depend on the presupposed case. The results also show that reasoners generate different situations to verify and falsify conditionals based on possibilities and facts.

Adult↗
PubMed2000

Illusions in modal reasoning.

According to the mental model theory, models represent what is true, but not what is false. One unexpected consequence is that certain inferences should have compelling, but invalid, conclusions. Three experiments corroborated the occurrence of such illusions in reasoning about possibilities. When problems had the heading "Only one of the premises is true," the participants considered the truth of each premise in turn, but neglected the fact that when one premise is true, the others are false. When two-premise problems had the heading "One of the premises is true and one is false," the participants still neglected the falsity of one of the premises. As predicted, however, the illusions were reduced when reasoners were told to check their conclusions against the constraint that only one of the premises was true. We discuss alternative explanations for illusory inferences and their implications for current theories of reasoning.

Cognition↗
PubMedDate not supplied

Reasons why emergency nurses take or do not take the certification examination in emergency nursing.

The purpose of this descriptive, exploratory study was to identify reasons that motivate the emergency nurse to take the Certification Exam for Emergency Nursing (CEN exam); reasons certified emergency nurses (CEN) give concerning their decisions to recertify; and a comparison of demographic characteristics in relation to these reasons. A random sample of 500 registered nurses who are currently members of the Emergency Nurses Association (ENA) and who are working in the emergency department was obtained from the ENA. These nurses received a questionnaire packet containing a cover letter explaining the purpose of the study, a combined Educational Participation Scale (EPS) and Deterrents to Participation Scale (DPS), a personal data questionnaire, and a return envelope.

Certification↗
PubMedDate not supplied

Assessing registered nurses' reasons for participating in continuing education.

Registered nurses (RNs) attending a national conference were surveyed to find out what motivated their participation in continuing professional education. Eight hundred sixty-six RNs completed the Participation Reasons Scale (PRS) and the Respondent Information Form (RIF). Five factors emerged from a factor analysis and several significant relationships were found between person-related and profession-related variables. These findings indicate that nurses are concerned with professional competence and participate in continuing education for complex reasons. This study can serve as the basis for further research and should be useful to those who teach or plan continuing education activities, promote them, select instructional techniques, and evaluate learning experiences. If, as current research indicates, continuing education contributes to quality practice, then reasons that influence participation take on an increasingly greater significance for the entire nursing profession.

Adult↗
PubMed2005

The effect of curricula approaches to the development of the student's clinical reasoning ability.

A comparative analysis was undertaken using descriptive and cross sectional survey design, to explore the effect of Problem Based Learning and Traditional approach on the development of clinical reasoning abilities of nursing students. Using quota sampling, a sample of 87 subjects was used from two University Nursing Departments, each using these curricula approaches. Students from their first, second and fourth year were interviewed, using the Triple Jump Exercise as an instrument to collect data. Data analysis using the SAS computer software package was employed to obtain both descriptive and statistical summarizations. Though descriptive analysis of the scores of clinical reasoning showed a slight difference between the two curricular approaches, this was not confirmed statistically as the two factor ANOVA and Tukey's methods revealed no significant differences by approaches. The only significant difference was revealed between the students' levels of study with senior levels (4th years) outperforming their juniors. These findings therefore conclude that, students using Problem Based Learning and Traditional approach perform on a similar level in clinical reasoning.

Analysis of Variance↗
PubMed1992

Clinical reasoning process for service provision in the public school.

This paper outlines the clinical reasoning process used to guide decisions on the provision of occupational therapy services in the Wake County Public School System in North Carolina. The process is based on a theoretical framework derived from occupational therapy theory and public law. Benefits of using the clinical reasoning process include (a) increased consistency of decision making among therapists; (b) increased appropriateness of decisions regarding whether a student needs educationally based occupational therapy services, what type of occupational therapy service would meet the student's need, and how often this service should be provided; and (c) improved ability of therapists to articulate to all those involved with a student the reasoning behind decisions to provide educationally based occupational therapy services. The schematic diagrams that depict this process provide a useful tool for therapists with varied work experiences entering school-based practice.

Child↗
PubMed1992

The classroom as clinic: applications for a method of teaching clinical reasoning.

This study examined the efficacy of one method for teaching diagnostic reasoning to occupational therapy students. During a clinical reasoning seminar in their first academic year, 80 entry-level occupational therapy master's degree students in three successive classes were given three different levels of exposure to classroom-as-clinic or in-class evaluations of adults with physical or psychosocial disabilities. During the following summer, most students completed their first Level II fieldwork experience. Students' grades for a second-year classroom-as-clinic experience with adults with physical disabilities were then compared across groups to determine the relative effect of the different seminar formats and fieldwork experiences. Students who had experienced in-class evaluations during their first academic year wrote significantly more accurate second-year evaluations than those who had not. Students who had completed psychosocial Level II fieldwork experiences were as accurate on their evaluations as students who had had physical dysfunction fieldwork experiences. The results suggest that in-class evaluations improve students' diagnostic reasoning skills.

Adult↗
PubMedDate not supplied

Using a head-mounted video camera to study clinical reasoning.

Studies of clinical reasoning are essential if we are to extend our knowledge of occupational therapy practice, better communicate our work to clients and colleagues, and reveal to our students the nuances of therapy that cannot be gained from texts. However, accessing therapists' clinical reasoning is not an easy task because these cognitive processes can be studied only indirectly. The aim of this article is to promote the study of clinical reasoning by reviewing a new approach to data collection in this field. To achieve this purpose, the article outlines current data collection methods, such as the think-aloud method written notes, free recall, and audio-assisted and video-assisted recall. A novel method involving a head-mounted video camera is described, and details are provided on a modified approach to debriefing using video-assisted recall. Anecdotes from the authors experience of using this technology illustrate the text.

Clinical Competence↗
PubMedDate not supplied

A comparative analysis of case presentation modalities used in clinical reasoning coursework in occupational therapy.

This study used mixed methods to compare four different styles of case presentation in a course designed to develop the clinical reasoning skills of master's level occupational therapy students. Modalities used to present cases were printed text, videotape, live interview, and CD-ROM movies delivered on an Internet platform. The researchers sought to determine the relative merits and limitations of each modality from both pedagogical and practical standpoints. Results indicate that the choice of modality does not compromise the ability of students to meet learning objectives related to clinical reasoning; however, several advantages and disadvantages with respect to practical aspects of presentation and learning were identified from instructor and student perspectives. The strength of the overall instructional format, and decisions concerning the amount and type of information provided in the cases were found to be more relevant to the quality of the learning experience than the modality of presentation. Recommendations are provided for structuring clinical reasoning learning experiences that combine the best features from the case modalities examined in this study.

Education, Professional↗
PubMed1998

Theoretical approaches to the study of nurses' clinical reasoning: getting things clear.

This paper attempts to clarify both the nature of clinical reasoning and the major theoretical underpinnings of studies that explore nurses' clinical reasoning. It includes a discussion of propositional and procedural knowledge ('knowing that' and 'knowing how') and their relationship in clinical reasoning. Prescriptive and descriptive and rational and phenomenological models are distinguished, and decision theory, information processing theory and (Dreyfusian) skills acquisition theory are discussed and compared.

Clinical Competence↗
PubMed2002

Projections of Australian obstetricians ceasing practice and the reasons.

OBJECTIVES: To assess the intentions of Australia's specialist obstetricians to cease practice and their reasons for abandoning this specialty. DESIGN: A structured questionnaire posted to Fellows of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), issued 11 July 2001 with a return date of 31 July 2001 (in practice, responses were accepted up to 31 August 2001). PARTICIPANTS: Australian specialists holding a Fellowship of the RANZCOG. MAIN OUTCOME MEASURES: Demographic data (eg, age, sex); type and location of practice; past, current and intended future obstetric practice; reasons for stopping practice; cost of indemnity premiums; experience of litigation and its influence on practice; and experience in giving medicolegal opinion. RESULTS: The response rate was 74% (829/1116), with 826 responses fulfilling our selection criteria. The median number of years since admission as a Fellow was 17 (range, 1-47 years), and 19% (158/817) of respondents were women (9 people did not specify their sex). Of the 826 respondents, 596 (72%) were currently practising obstetrics, 548 (66%) intended to still be practising after one year, 365 (44%) intended to be practising after five years, and 196 (24%) intended to be practising after 10 years. The median indemnity premium in 2001-02 was $35,515 (range, nil to $156,000) for practising obstetricians. The main reasons given for ceasing obstetrics were intention to specialise in gynaecology, fear of litigation, high indemnity costs, family disruption, and long working hours. About two-thirds of respondents (557/818) had experienced the threat of litigation, and almost all (768/803) desired some type of "no-fault" indemnity scheme. Thirty-three of the 314 respondents who had given medicolegal opinions accounted for 71% of the total number of opinions. Many of these were non-practising obstetricians who were not accredited RANZCOG expert witnesses. CONCLUSION: There will soon be a shortage of experienced practising obstetricians in Australia.

Adult↗
PubMed2002

Outpatient phlebotomy success and reasons for specimen rejection.

OBJECTIVES: To determine the rate with which blood collection is successful on the initial phlebotomy encounter, the rate with which laboratory personnel judge specimens unsuitable for analysis, and the practice characteristics associated with fewer unsuccessful collections and fewer rejected specimens. DESIGN: Clinical laboratories participating in the College of American Pathologists Q-Probes laboratory improvement program prospectively characterized the outcome of outpatient phlebotomies for 3 months or until 20 unsuccessful phlebotomy encounters occurred. By questionnaire, participants provided information about test ordering, patient preparation, and specimen collection. SETTING AND PARTICIPANTS: Institutions in the United States (n = 202), Canada (n = 4), Australia (n = 3), and South Korea (n = 1). MAIN OUTCOME MEASURES: Percentage of successful encounters and percentage of unsuitable specimens. RESULTS: Of 833289 encounters, 829723 were successful. Phlebotomies were unsuccessful because patients were not fasting as directed (32.2%), phlebotomy orders were missing information (22.5%), patients specimens were difficult to draw (13.0%), patients left the collection area before specimens were collected (11.8%), patients were improperly prepared for reasons other than fasting (6.3%), patients presented at the wrong time (3.1%), or for other reasons (11.8%). Only 2153 specimens (0.3%) were unsuitable; these samples were hemolyzed (18.1%), of insufficient quantity (16.0%), clotted (13.4%), lost or not received in the laboratory (11.5%), inadequately labeled (5.8%), at variance with previous or expected results (4.8%), or unacceptable for other reasons (31.1%). Facilities staffed by laboratory-administered phlebotomists reported higher success rates than facilities staffed by nonlaboratory-administered phlebotomists (P =.002). CONCLUSIONS: Most outpatient phlebotomy encounters are successful and result in specimens suitable for laboratory analysis.

Australia↗
PubMed1998

[Clinical reasoning learning (CRL) sessions. An example of a contextualized teaching activity adapted to clinical stages in medicine].

Clinical reasoning learning (CRL) sessions stem from an educational reform brought about since 1987 at the Faculty of Medicine of the Université de Sherbrooke. This reform is student-centered and based on situated learning and teaching. The objective of the CRL sessions, designed and implemented at the clerkship level, is to help students develop problem solving competencies through the use of effective general clinical reasoning strategies and the development of a highly organized network of specific knowledge. These sessions also strive to offset the difficulties of random clinical exposure and often highly complex cases encountered by trainees during clinical rotations in teaching hospitals. Formed of small groups, sessions recreate a clinical consultation setting focused on a specific priority problem and clinical condition identified among the mandatory objectives of the rotation. Emphasis is placed on early generation and subsequent testing of diagnostic hypothesis, and the active search and gradual disclosure of clinical data using hypothesis-driven inquiry strategy. Students are asked to verbalize their reasoning process under the close supervision of a clinical expert in the field under discussion. Implemented in 5 different clinical disciplines since 1990 in Sherbrooke, assessment data are now available and support the relevance and usefulness of CRL sessions.

Canada↗
PubMed1991

"Reasonable accommodation" under the Americans with Disabilities Act--what does it mean?

The Americans with Disabilities Act (ADA) imposes on employers the duty to afford qualified disabled applicants and employees "reasonable accommodation," but provides minimal guidance as to the range of actions necessary to fulfill this duty. Under the statutory scheme, required accommodations will vary from employer to employer, from worksite to worksite for the same employer, and perhaps even from employee to employee at the same worksite. Personnel managers will be required to make very fact-specific decisions in each case as to whether to offer particular accommodations, with any decision declining to provide the accommodation subject to attack in litigation. Based on an analysis of how similar reasonable accommodation requirements have been interpreted under other statutes, this article analyzes the likely parameters of the duty to afford reasonable accommodation under the ADA and offers specific suggestions for employers to minimize their risk of liability.

Architectural Accessibility↗