| Clinical reasoning processes: unravelling complexity through graphical representation. | |
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MedLine Citation:
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PMID: 22515753 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Medical Education 2012: 46: 454-463 Context Clinical reasoning is a core skill in medical practice, but remains notoriously difficult for students to grasp and teachers to nurture. To date, an accepted model that adequately captures the complexity of clinical reasoning processes does not exist. Knowledge-modelling software such as mot Plus (Modelling using Typified Objects [MOT]) may be exploited to generate models capable of unravelling some of this complexity. Objectives This study was designed to create a comprehensive generic model of clinical reasoning processes that is intended for use by teachers and learners, and to provide data on the validity of the model. METHODS Using a participatory action research method and the established modelling software (mot Plus), knowledge was extracted and entered into the model by a cognitician in a series of encounters with a group of experienced clinicians over more than 250 contact hours. The model was then refined through an iterative validation process involving the same group of doctors, after which other groups of clinicians were asked to solve a clinical problem involving simulated patients. Results A hierarchical model depicting the multifaceted processes of clinical reasoning was produced. Validation rounds suggested generalisability across disciplines and situations. Conclusions The MOT model of clinical reasoning processes has potentially important applications for use within undergraduate and graduate medical curricula to inform teaching, learning and assessment. Specifically, it could be used to support curricular development because it can help to identify opportune moments for learning specific elements of clinical reasoning. It could also be used to precisely identify and remediate reasoning errors in students, residents and practising doctors with persistent difficulties in clinical reasoning. |
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Authors:
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Bernard Charlin; Stuart Lubarsky; Bernard Millette; Françoise Crevier; Marie-Claude Audétat; Anne Charbonneau; Nathalie Caire Fon; Lea Hoff; Christian Bourdy |
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Publication Detail:
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Type: JOURNAL ARTICLE |
Journal Detail:
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Title: Medical education Volume: 46 ISSN: 1365-2923 ISO Abbreviation: - Publication Date: 2012 May |
Date Detail:
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Created Date: 2012-4-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7605655 Medline TA: Med Educ Country: - |
Other Details:
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Languages: ENG Pagination: 454-463 Citation Subset: - |
Copyright Information:
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© Blackwell Publishing Ltd 2012. |
Affiliation:
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Centre for Applied Pedagogy in Health Sciences (Centre de Pédagogie Appliquée aux Sciences de la Santé [CPASS]), University of Montreal, Montreal, Quebec, Canada Centre for Medical Education, McGill University, Montreal, Quebec, Canada Department of Neurology, Montreal General Hospital, Montreal, Quebec, Canada Department of Family and Emergency Medicine, Hôpital Cité de la Santé de Laval, Quebec, Canada Consultant, Educational Engineering, Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada Department of Family and Emergency Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada Department of Oral Health, Faculty of Dental Medicine, University of Montreal, Montreal, Quebec, Canada Department of Medicine, CPASS, University of Montreal, Montreal, Quebec, Canada. |
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