Learning Clinical Reasoning from Examples

Kassirer, Jerome P.; Kopelman, Richard I.

doi:10.1080/21548331.1989.11703675

Cited by 71 publications

(111 citation statements)

References 2 publications

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“…Yet, this does not imply that one cannot teach beyond "repeated practice [-] on a similar range of problems" (Elstein et al 1978) or "observing others engaged in the process" (Kassirer and Kopelman 1991). What can be done?…”

Section: Teaching Clinical Reasoning: a Few General Recommendationsmentioning

confidence: 99%

“…During sessions, students should be encouraged to actively participate and take notes -the importance of which was already emphasized by William Osler. To avoid the "retrospective bias" -teaching problem solving as if one is working toward a solution known in advance -the method works best when the teacher or tutor is not familiar with the case but has access to exactly the same information as the students (Kassirer 2010;Kassirer and Kopelman 1991). Critics might argue that this is a reduced form of clinical problem solving -and it is, deliberately so -for clinical reasoning is demanding and involves a high cognitive load (Qiao et al 2014;Young et al 2014); hence, it cannot be properly taught in an authentic context, where students simultaneously have to deal with a real patient: in this context, dealing with a real patient would impose "extraneous load" to the detriment of the "germane load," i.e., learning (van Merriënboer and Sweller 2010).…”

Section: Teaching Clinical Reasoning: a Few General Recommendationsmentioning

confidence: 99%

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Training Clinical Reasoning: Historical and Theoretical Background

Custers¹

2017

Innovation and Change in Professional Education

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In this chapter, we will try to give a concise overview of what is known about teaching clinical reasoning in the era before the concept of "clinical reasoning" as such emerged in the literature. Not surprisingly, the further we go back in time, the more this concept needs to be stretched to fit what can arguably be seen as the predecessors of today's clinical teaching and diagnostic reasoning. Yet, even in the earliest days of medicine, teachers taught students how to make sense of the findings associated with diseases (patients' complaints, signs, and symptoms) and how to use this knowledge to ameliorate a patient's condition, if this could be achieved at all. Starting in the 1950s, clinical reasoning itself became a subject of study, which increasingly enabled clinical educators to advance beyond merely showing and telling students how to apply knowledge and skills in a practical setting, to building theories and models of how clinical reasoning can be effectively and efficiently trained. Clinical Reasoning in the Hippocratean EraThrough all ages, humans have tried to make sense of complaints, symptoms, and diseases; in this sense, clinical reasoning is as old as humanity. In the pre-Hippocratic era, people relied on priests or other authoritative individuals who had privileged access to the intentions divine entities had with the sufferer or with society as a whole, for diseases were sometimes seen -by patients as well as by healers -as containing messages from above. Similarly, the cause of a disease could be couched

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Section: Teaching Clinical Reasoning: a Few General Recommendationsmentioning

confidence: 99%

Section: Teaching Clinical Reasoning: a Few General Recommendationsmentioning

confidence: 99%

Training Clinical Reasoning: Historical and Theoretical Background

Custers¹

2017

Innovation and Change in Professional Education

View full text Add to dashboard Cite

show abstract

“…The process of differential diagnosis 8 can be difficult to apply to any rare disease. Unfamiliarity may impede the generation of diagnostic hypotheses, objective diagnostic opinion may be elusive, and criteria for whether and when to order supporting investigations may be unclear.…”

Section: When May Sporadic Cjd Be Suspected?mentioning

confidence: 99%

“…8,29 A brief review of this approach is presented in Appendix 1. In this review, we summarize the data of 13 published studies within such a framework.…”

mentioning

confidence: 99%

Interpretation of cerebrospinal fluid protein tests in the diagnosis of sporadic Creutzfeldt–Jakob disease: an evidence-based approach

Coulthart

Jansen

Cashman

2014

CMAJ

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P rion diseases are rare, lethal, untreatable degenerative brain disorders of humans and animals. They are linked to conversion of a specific brain protein from its normal form (PrP C ) into a misfolded, pathologic form (PrP Sc ) and are transmissible between individuals by a novel protein-based mechanism.1 Because there is no convincing evidence for causation by a conventional microbial patho gen, and because even a minute quantity of exogenous material containing PrP Sc can initiate a cascade of PrP C conversion in a new host in a manner reminiscent of infection, the term "prion" was coined to denote the implicated proteinaceous infectious particle.

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“…10 The final working diagnosis must be adequate and coherent-that is, it must explain most normal and abnormal findings and conform to the patient's demographics, presentation, and clinical course. Stated otherwise, there must be a reasonable (but as clinicians know, rarely perfect) match between the clinical features of the patient in front of them and the illness script (ie, template of the disease) in their mind.…”

Section: Hypothetico-deductive Modelmentioning

confidence: 99%