Clinical Competence: General Ability or Case-specific?

Wimmers, Paul F.; Splinter, Ted A.W.; Hancock, Gregory R.; Schmidt, Henk G.

doi:10.1007/s10459-006-9002-x

Cited by 32 publications

(35 citation statements)

References 34 publications

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“…Only 2 cases were used in the study which may have resulted in a case specificity effect (ie, an individual's ability to solve problems varies across cases), implying that the results from these 2 cases may not apply to other cases. 22 In addition to the low number of cases used in the study, an unanticipated yet significant case effect was found that impacted the results and highlights the need for using factual evidence when responding to highly sensitive topics and legal/ethical dilemmas.…”

Section: Discussionmentioning

confidence: 91%

Relationship Between Case Question Prompt Format and the Quality of Responses

Medina

2010

American Journal of Pharmaceutical Education

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Objectives. To compare the effectiveness of 2 case question formats (multiple choice and open ended) to prompt faculty members and students to explore multiple solutions and use factual evidence to defend their solutions. Methods. Doctor of pharmacy (PharmD) faculty members and students responded to 2 pharmacy law/ ethics cases, one followed by a case question prompt in multiple-choice format and the other by a question in open-ended format. The number of conclusions and the quality of the arguments generated were assessed using general linear modeling. Results. PharmD faculty members outperformed students on every outcome variable measured, demonstrating expert problem-solving skills. All participants provided better quality arguments when the case prompt question was in multiple-choice format. Conclusions. The better quality arguments prompted by multiple-choice case questions suggests this format should be used when constructing case question prompts.

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Section: Discussionmentioning

confidence: 91%

Relationship Between Case Question Prompt Format and the Quality of Responses

Medina

2010

American Journal of Pharmaceutical Education

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“…Performance on one medical case does not necessarily predict performance on subsequent cases because case specificity leads to different performance outcomes (Fitzgerald et al, 1994;van der Vleuten & Swanson, 1990;Wimmers et al, 2006). In fact, the correlation between diagnostic performances across cases has been reported as low as 0.1 to 0.3 (Norman, Tugwell, Feighter, Muzzin, & Jacoby, 1985).…”

Section: Related Workmentioning

confidence: 99%

“…Research investigating clinical reasoning has illustrated the importance of case specificity in medical education (Fitzgerald et al, 1994;van der Vleuten & Swanson, 1990;Wimmers, Splinter, Hancock, & Schmidt, 2006); this phenomenon refers to the variability in performance from case to case in medical problem solving. The prior knowledge that is associated with different diseases and their underlying physiological processes, combined with the prevalence of certain diseases, opportunities to encounter them in practice and gather detailed information, means that cases may vary in their level of difficulty.…”

Section: Introductionmentioning

confidence: 99%

A Tale of Three Cases: Examining Accuracy, Efficiency, and Process Differences in Diagnosing Virtual Patient Cases

Doleck

Jarrell

Poitras

et al. 2016

AJET

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Clinical reasoning is a central skill in diagnosing cases. However, diagnosing a clinical case poses several challenges that are inherent to solving multifaceted ill-structured problems. In particular, when solving such problems, the complexity stems from the existence of multiple paths to arriving at the correct solution (Lajoie, 2003). Moreover, the approach one employs in diagnosing a clinical case is in some measure dependent upon the complexity of the case. This leads us to the question: Are there differences in the manner in which novices solve cases with varying levels of complexity in a computer-based learning environment? More specifically, we are interested in understanding and elucidating if there are clinical reasoning differences in regards to accuracy, efficiency, and process across three virtual patient cases of varying difficulty levels. Examining such differences may have implications from both a learner modelling and system enhancement perspective. We close by discussing the implications for practice, limitations of the study and future research directions.

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“…In a study involving medical students, on ten different clerkships/rotations, structural equation modelling demonstrated that in some contexts nearly 40% of reasoning seemed to relate to general problem solving ability 29 .…”

Section: Generic Reasoning Skillmentioning

confidence: 99%

Clinical Reasoning and Case-Based Decision Making: The Fundamental Challenge to Veterinary Educators

May¹

2013

Journal of Veterinary Medical Education

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Confusion about the nature of human reasoning and its appropriate application to patients has hampered veterinary students' development of these skills. Expertise is associated with greater ability to deploy pattern recognition (type 1 reasoning), which is aided by progressive development of data-driven, forward reasoning (in contrast to scientific, backward reasoning), analytical approaches that lead to schema acquisition. The associative nature of type 1 reasoning makes it prone to bias, particularly in the face of “cognitive miserliness,” when clues that indicate the need for triangulation with an analytical approach are ignored. However, combined reasoning approaches, from the earliest stages, are more successful than one approach alone, so it is important that those involved in curricular design and delivery promote student understanding of reasoning generally, and the situations in which reasoning goes awry, and develop students' ability to reason safely and accurately whether presented with a familiar case or with a case that they have never seen before.

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Clinical Competence: General Ability or Case-specific?

Cited by 32 publications

References 34 publications

Relationship Between Case Question Prompt Format and the Quality of Responses

Relationship Between Case Question Prompt Format and the Quality of Responses

A Tale of Three Cases: Examining Accuracy, Efficiency, and Process Differences in Diagnosing Virtual Patient Cases

Clinical Reasoning and Case-Based Decision Making: The Fundamental Challenge to Veterinary Educators

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