scholarly journals A workshop to train medicine faculty to teach clinical reasoning

Diagnosis ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. 109-113 ◽  
Author(s):  
Verity Schaye ◽  
Michael Janjigian ◽  
Kevin Hauck ◽  
Neil Shapiro ◽  
Daniel Becker ◽  
...  
Keyword(s):  
Clinical Reasoning ◽  
Role Play ◽  
Core Competency ◽  
Problem Representation ◽  
Preliminary Evaluation ◽  
Educational Strategies ◽  
Teaching Techniques ◽  
Commitment To Change ◽  
Case Based

Abstract Background Clinical reasoning (CR) is a core competency in medical education. Few studies have examined efforts to train faculty to teach CR and lead CR curricula in medical schools and residencies. In this report, we describe the development and preliminary evaluation of a faculty development workshop to teach CR grounded in CR theory. Methods Twenty-six medicine faculty (nine hospitalists and 17 subspecialists) participated in a workshop that introduced a framework to teach CR using an interactive, case-based didactic followed by role-play exercises. Faculty participated in pre- and post-Group Observed Structured Teaching Exercises (GOSTE), completed retrospective pre-post assessments (RPPs), and made commitment to change statements (CTCs). Results In the post-GOSTE, participants significantly improved in their use of problem representation and illness scripts to teach CR. RPPs revealed that faculty were more confident in their ability and more likely to teach CR using educational strategies grounded in CR educational theory. At 2-month follow-up, 81% of participants reported partially implementing these teaching techniques. Conclusions After participating in this 3-h workshop, faculty demonstrated increased ability to use these teaching techniques and expressed greater confidence and an increased likelihood to teach CR. The majority of faculty reported implementing these newly learned educational strategies into practice.

Clinical Reasoning, Part 2: Novice/Expert Differences

1996 ◽  
Vol 59 (5) ◽  
pp. 212-216 ◽  
Author(s):  
Linda J Robertson
Keyword(s):  
Problem Solving ◽  
Occupational Therapy ◽  
Treatment Planning ◽  
Clinical Reasoning ◽  
Problem Representation ◽  
Educational Strategies ◽  
New Model ◽  
Concrete Experience ◽  
Further Development ◽  
Problem Representations

In part 1, a model of problem solving in occupational therapy was presented; the problem-representation component of this has now been developed to depict the differences between student and clinician in problem representation. This new model illustrates that both students and clinicians have access to the same information but that this is more clearly defined and organised in the clinician. The abstract, unlinked data of the student are ultimately transformed by concrete experience to a rich supply of schemata, which then become the basis for further development of problem representations in a particular area of practice. Clinicians frequently weave a human perspective into their understanding of the client whereas students, although able to note the client's concerns, are more likely to treat this information as another piece of data than to integrate it into treatment planning. A number of educational strategies are discussed.

scholarly journals Understanding the clinical reasoning processes involved in the management of multimorbidity in an ambulatory setting: study protocol of a stimulated recall research

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M.-C. Audétat ◽  
S. Cairo Notari ◽  
J. Sader ◽  
C. Ritz ◽  
T. Fassier ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Reasoning ◽  
Primary Care Physicians ◽  
Video Sequence ◽  
Structured Interview ◽  
Ambulatory Setting ◽  
Structured Interviews ◽  
Stimulated Recall ◽  
Study Results

Abstract Background Primary care physicians are at the very heart of managing patients suffering from multimorbidity. However, several studies have highlighted that some physicians feel ill-equipped to manage these kinds of complex clinical situations. Few studies are available on the clinical reasoning processes at play during the long-term management and follow-up of patients suffering from multimorbidity. This study aims to contribute to a better understanding on how the clinical reasoning of primary care physicians is affected during follow-up consultations with these patients. Methods A qualitative research project based on semi-structured interviews with primary care physicians in an ambulatory setting will be carried out, using the video stimulated recall interview method. Participants will be filmed in their work environment during a standard consultation with a patient suffering from multimorbidity using a “button camera” (small camera) which will be pinned to their white coat. The recording will be used in a following semi-structured interview with physicians and the research team to instigate a stimulated recall. Stimulated recall is a research method that allows the investigation of cognitive processes by inviting participants to recall their concurrent thinking during an event when prompted by a video sequence recall. During this interview, participants will be prompted by different video sequence and asked to discuss them; the aim will be to encourage them to make their clinical reasoning processes explicit. Fifteen to twenty interviews are planned to reach data saturation. The interviews will be transcribed verbatim and data will be analysed according to a standard content analysis, using deductive and inductive approaches. Conclusion Study results will contribute to the scientific community’s overall understanding of clinical reasoning. This will subsequently allow future generation of primary care physicians to have access to more adequate trainings to manage patients suffering from multimorbidity in their practice. As a result, this will improve the quality of the patient’s care and treatments.

scholarly journals Neurosciences in Buddhist India

2018 ◽  
Vol 07 (03) ◽  
pp. 176-178 ◽  
Author(s):  
Arushi Kumar ◽  
Raj Kumar
Keyword(s):  
Human Body ◽  
Preoperative Evaluation ◽  
Operative Procedure ◽  
Thought Process ◽  
Human Beings ◽  
Neurologic Disorders ◽  
Mind Control ◽  
Control Of Thoughts ◽  
Case Based

AbstractNeurosciences in Buddhist era was mainly based on power of mind and thoughts. It emphasized mainly about the power of mind, control of thoughts, purification, and modifications of erroneous thought process, which should result in truthful and correct practices and subsequent actions by human beings to remain happy. Buddhism believes that most diseases of human body are secondary to mind and that these can be healed by controlling the erroneous thoughts and practices of Dhamma. Though the treatment for neurologic disorders such as headache, stress, and anxiety was primitive, it was mainly based on purification of mind and righteous pathway of Dhamma followed by medicines, modification in dietary and other living habits, etc. Enough evidence (including operated case-based commentary) shows that cranial surgery was also performed following appropriate diagnosis. The concept of diagnosis, preoperative evaluation, explanation to the patient, operative procedure, perioperative care, and follow-up was also present in that era.

scholarly journals Clinical Reasoning as a Core Competency

2019 ◽  
Vol 95 (8) ◽  
pp. 1166-1171 ◽  
Author(s):  
Denise M. Connor ◽  
Steven J. Durning ◽  
Joseph J. Rencic
Keyword(s):  
Clinical Reasoning ◽  
Core Competency

scholarly journals What Ifs and Multi-directional symptoms PBL cases: two simple and functional adjuncts to problem-based learning materials

2019 ◽  
Vol 27 (8) ◽  
Author(s):  
Jeff Schwartz
Keyword(s):  
Medical Education ◽  
Clinical Reasoning ◽  
Problem Based Learning ◽  
New Materials ◽  
Learning Materials ◽  
Case Based Learning ◽  
Patient Presentation ◽  
Case Based ◽  
Management Issues

Although problem-based learning (PBL) is widely used in medical education for its many virtues, a number of deficiencies exist. As means of enhancing the experience of PBL for students, two relatively simple adjuncts to PBL are presented. What Ifs are short hypothetical scenarios, appended to the end of a PBL case, that require students to revisit elements of the PBL case just completed and apply their newly acquired knowledge to clinical reasoning in an altered scenario or to explore anew another dimension of the PBL case. Multi-directional symptoms PBL cases are cases where a common presenting symptom, rather than a specific pathology, is the focus of the PBL case and, following a core narrative of the initial patient presentation, a series of independent continuation narratives with appropriate histories, examination findings and investigation results, lead students to divergent diagnoses and management issues. In addition to keeping the PBL process fresh by rotating new materials regularly, these adjuncts extend the PBL process in the direction of case-based learning.

scholarly journals The Effect of Teaching Techniques and Learning Styles to Improve Students’ Speaking Skill

2018 ◽  
Vol 1 (2) ◽  
pp. 48-59
Author(s):  
Rani Dewi Yulyani
Keyword(s):  
Data Analysis ◽  
Learning Styles ◽  
Learning Style ◽  
Role Play ◽  
English Department ◽  
Teaching Techniques ◽  
Speaking Test ◽  
Significant Difference ◽  
Speaking Skill

This research aims, firstly, to analyze the significant effect of role-play and discussion techniques on the students’ speaking skill. Secondly, to analyze the significant difference of the students who are holistic learners with those who are sequential learners regarding their speaking skill. Thirdly, to discuss the interaction regarding the teaching techniques and learning style concerning the students’ speaking skill. The objects of the research were two classes of English department students, Universitas Pamulang (UNPAM). The instruments used were the speaking test and questionnaires. The method of the data analysis was quantitative using SPSS 20. The result of the research shows, firstly, there was a significant effect of the role-play technique and discussion on the students’ speaking skill. Secondly, there was no significant difference concerning the students who are holistic learners with those who are sequential learners, regarding the speaking skill. Thirdly, there was no interaction between teaching techniques and learning styles in relation with students’ speaking skill.

scholarly journals Ropeginterferon alfa-2b every 2 weeks as a novel pegylated interferon for patients with chronic hepatitis B

2020 ◽  
Author(s):  
Yi-Wen Huang ◽  
Chao-Wei Hsu ◽  
Sheng-Nan Lu ◽  
Ming-Lung Yu ◽  
Chien-Wei Su ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Hbeag Seroconversion ◽  
Pegylated Interferon ◽  
Preliminary Evaluation ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Ropeginterferon alfa-2b is a novel mono-pegylated interferon that has only one major form as opposed to 8–14 isomers of other on-market pegylated interferon, allowing injection every two or more weeks with higher tolerability. It received European Medicines Agency and Taiwan marketing authorization in 2019 and 2020, for treatment of polycythemia vera. This phase I/II study aimed to have preliminary evaluation of safety and efficacy in chronic hepatitis B. Methods Thirty-one HBeAg-positive and 31 HBeAg-negative were stratified by HBeAg status and randomized at 1:1:1 ratio to q2w ropeginterferon alfa-2b 350 μg (group 1), q2w 450 μg (group 2) or q1w PEG-IFN alfa-2a 180 μg (group 3). Each patient received 48-week treatment (TW48) and 24-week post-treatment follow-up (FW24). Results The baseline demographics were comparable among the three groups, except for mean HBeAg in HBeAg-positive patients (2.90, 2.23, 2.99 log10 S/CO, respectively). Cumulative HBeAg seroconversion rate at follow-up period was 27.3% (3/11), 36.4% (4/11), and 11.1% (1/9) with time to HBeAg seroconversion starting from TW24, TW16, and TW48 in group 1, 2, and 3, respectively. The rate of HBV DNA < 2000 IU/mL and HBsAg levels < 1500 IU/mL at FW24 were comparable in all groups. Ropeginterferon alfa-2b (group 1 & 2) had numerically lower incidence of rash (9.5% and 4.5%) as compared to PEG-IFN alfa-2a (36.8%). Ropeginterferon alfa-2b 350 μg (group 1) had more ALT elevation (38.1%), however the rate was comparable in group 2 (9.1%) and group 3 (10.5%). Conclusion In this preliminary study, ropeginterferon alfa-2b, although in only half the number of injections, is as safe and effective as pegylated interferon alfa-2a for chronic hepatitis B. Graphic abstract

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