Medical residents were randomly assigned to either a 20-minute session on the importance of screening for domestic violence or to an unrelated topic. Subsequently, 71 percent of the trained residents diagnosed at least one case of domestic violence compared to 52 percent of residents in the control group. Rates of diagnosis also differed by…

A study examined trends in the volume and type of inpatient clinical diagnoses, common medical services, and specialized services in academic medical centers (AMCs)--integrated and independent, other teaching hospitals, and nonteaching hospitals. Results indicate that despite rapid change in the health care environment, little change has occurred…

It is proposed that, contrary to existing views, medical expertise is not as much a matter of superior reasoning skills or in-depth knowledge of pathophysiological states as it is based on cognitive structures describing the features of prototypical or actual patients. Evidence supporting the theory is examined. (Author/MSE)

A study investigated whether the more efficiently graded extended-matching questions were equivalent to short-answer questions in evaluating medical students' (n=98) ability to elicit physical findings and generate diagnoses and treatment plans, using standardized-patient examinations. The differences found in the two question types did not favor…

Responses to questionnaires were compared between 106 students in nursing homes with those of 171 students in hospitals to evaluate interview and physical examination instruction for medical students. The nursing home was assessed as an appropriate alternative site for teaching the medical interview and physical diagnosis. (GLR)

An approach to testing medical students' clinical decision-making skills identifies key features (critical steps in resolution of a clinical problem) and presents a clinical case scenario followed by questions focusing on those key features. Key-feature problems provide flexibility on issues of question format, multiple responses to questions, and…

This study examined the effects of similarity to prior examples in predicting errors in dermatologic diagnosis. Two interpretations about the acquisition of expertise are independent cues and instance-based categorization. The subjects (N=16) were first-year family medicine residents from McMaster University (Ontario). (MLW)

This study compared the analytic scores on an essay test of clinical judgment generated by nonphysician readers with those of physician readers. Generalizability theory was applied to determine the number of essays and scorers required to reach specified levels of reproducibility. Results suggested that with training nonphysicians could…

The computer-based PlanAlyzer program was designed to teach clinical diagnosis to medical students, taking into account several characteristics common to the clinical problem solver: limited capacity for short-term memory; use of heuristic strategies; sequential information seeking; and problem conceptualization. Six years of development and…

A study involving 14 experienced physicians investigated the effectiveness of a computer program (providing statistical feedback to teach a clinical diagnostic rule that predicts the probability of streptococcal pharyngitis), in conjunction with traditional lecture and periodic disease-prevalence reports. Results suggest the integrated method is a…

The objective of this study was to identify characteristics of the patient, training process, and test that were associated with the accuracy of the standardized patient's presentation of the clinical problem. The cohort consisted of 38 patients who were used to evaluate 98 medical students at the University of Manitoba in 1988. (MLW)

A one-month, elective fourth-year medical school course in advanced physical diagnosis is described. The course featured organ-specific didactic and interactive practice sessions, physical examination-based case conferences, professorial rounds with use of professional patients, and objective structured clinical examinations. (Author/MSE)

An educational intervention was effective in improving the judgment of experienced student-health physicians (N=11) in predicting positive culture in simulated patients with pharyngitis. The intervention was three parts: an initial one-hour lecture; three sessions with computer-based cognitive feedback; and monthly reports of the percentage of…

In August and September of 1989, 76 fourth year students at the University of Arizona College of Medicine took the objective structured clinical examinations. Analyses were conducted looking at the relationship of sequence to see whether scores showed a decrease in the afternoon. No significant effect of examinee fatigue was seen. (MLW)

An Oregon Health Sciences University medical school experiment adapted the quarterly Objective Structured Clinical Examination, in which medical students interact with standardized patients, to accommodate 23 small groups rather than 94 individual students at each testing station. Results indicated the method favorably influenced students,…