Context specificity and the impact that contextual factors have on the complex process of clinical reasoning is poorly understood. Using situated cognition as the theoretical framework, our aim was to evaluate the verbalized clinical reasoning processes of resident physicians in order to describe what impact the presence of contextual factors have…

Objectives: Resident physicians report insufficient experience caring for patients with substance use disorders (SUDs). Resident training in Screening, Brief Intervention, and Referral to Treatment (SBIRT) has been recommended. We describe the development of a standardized patient (SP) assessment to measure SBIRT skills, resident perceptions of…

Introduction: Electronic knowledge resources have the potential to rapidly provide answers to clinicians' questions. We sought to determine clinicians' reasons for searching these resources, the rate of finding relevant information, and the perceived clinical impact of the information they retrieved. Methods: We asked general internists, family…

Context specificity, or the variation in a participant's performance from one case, or situation, to the next, is a recognized problem in medical education. However, studies have not explored the potential reasons for context specificity in experts using the lens of situated cognition and cognitive load theories (CLT). Using these theories, we…

Clinicians routinely report fewer features in a case than they subsequently agree are present. The authors report studies that assess the effect of considering a more comprehensive description than physicians usually offer. These comprehensive descriptions were generated from photographs of dermatology and internal medicine and were complete and…

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…

In an attempt to replicate an earlier study by H. G. Schmidt, H. P. A. Boshuizen, and P. P. M. Hobus (1988), 96 students and physicians at the University of Limburg (Netherlands) studied 4 clinical cases, produced a diagnosis, and recalled each case. Subjects were 24 second-year, 24 fourth-year, and 24 sixth-year medical students and 24 internists…

In the present study, task instruction and lab data format were manipulated to explain the discrepancy between the positive linear recall function with expertise (reported by van de Wiel and others, 1993), and the generally found intermediate effect in clinical case recall. Sixteen second-year medical students, 16 fourth-year students, and 16…

The effectiveness of medical consultation studied at Johns Hopkins Hospital was measured as a function of compliance by the requesting physicians with the consultants' recommendations. Compliance rates are discussed. The definitiveness of the advice offered was significantly related to compliance. (MLW)

A problem-based continuing medical education program to improve the diagnosis and treatment of alcoholism by primary care physicians used a computer-simulated patient, individualized feedback, and a follow-up reading. Participating physicians felt the program improved their performance, but the results could not be substantiated. (MSE)

A study of six distinguished clinical teachers in internal medicine investigated how they made rapid instructional decisions in response to each case presentation in teaching rounds. Results indicated these characteristics: substantial planning before rounds; quick, simultaneous diagnosis of patient problems and learners' level of understanding;…