Teaching medical decision making and students' clinical problem solving skills

1991 ◽  
Vol 13 (2) ◽  
pp. 157-164 ◽  
Author(s):  
John C. Rogers ◽  
David E. Swee ◽  
John A. Ullian
1995 ◽  
Vol 41 (8) ◽  
pp. 1215-1222 ◽  
Author(s):  
M Werner

Abstract Clinicians confront the classical problem of decision making under uncertainty, but a universal procedure by which they deal with this situation, both in diagnosis and therapy, can be defined. This consists in the choice of a specific course of action from available alternatives so as to reduce uncertainty. Formal analysis evidences that the expected value of this process depends on the a priori probabilities confronted, the discriminatory power of the action chosen, and the values and costs associated with possible outcomes. Clinical problem-solving represents the construction of a systematic strategy from multiple decisional building blocks. Depending on the level of uncertainty the physicians attach to their working hypothesis, they can choose among at least four prototype strategies: pattern recognition, the hypothetico-deductive process, arborization, and exhaustion. However, the resolution of real-life problems can involve a combination of these game plans. Formal analysis of each strategy permits definition of its appropriate a priori probabilities, action characteristics, and cost implications.


1989 ◽  
Vol 69 (6) ◽  
pp. 441-447 ◽  
Author(s):  
Diane S Slaughter ◽  
Debra S Brown ◽  
Davis L Gardner ◽  
Lea J Perritt

2020 ◽  
Author(s):  
Alexander Joseph Mullen ◽  
Cathy Hsi Chen

UNSTRUCTURED Amid the COVID-19 crisis, we have witnessed true physicianship as our frontline doctors apply clinical problem-solving to an illness without a textbook algorithm. Yet, for over a century, American medical education has plowed ahead with a system that prioritizes content delivery over problem-solving. As resident trainees, we are acutely aware that memorizing content is not enough. We need a preclinical system designed to steer early learners from “know” to “know how.” Education leaders have long advocated for such changes to the medical school structure. For what may be the first time, we have a real chance to effect change. In response to the pandemic, medical educators have scrambled to conform curricula to social distancing mandates. The resulting online infrastructures are a rare chance for risk-averse medical institutions to modernize how we train our future physicians—starting by eliminating the traditional classroom lecture. Institutions should capitalize on new digital infrastructures and curricular flexibility to facilitate the eventual rollout of flipped classrooms—a system designed to cultivate not only knowledge acquisition but problem-solving skills and creativity. These skills are more vital than ever for modern physicians.


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