In an effort to better align item development to goals of assessing higher-order tasks and decision making, complex decision trees were developed to follow clinical reasoning scripts and used as models on which multiple-choice questions could be built. This approach is compatible with best-practice assessment frameworks like Evidence Centered…

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…

It is the responsibility of the athletic trainer to diagnose the nature and extent of an injury to an athlete, administer prompt first aid treatment, prevent any exacerbation of the injury, and hospitalize the patient quickly if it is necessary. The importance of these responsibilities is emphasized when an athlete suffers an injury to the abdomen…

An innovative internal medicine clerkship provides a one-month ambulatory care component followed by two months of traditional inpatient experience. Assessment of the changes in student ability to diagnose in a variety of brief cases found knowledge gains in the shorter ambulatory care segment were double those in the longer segment. (MSE)

Some of the differences between in-hospital and ambulatory medicine and their implications for the teaching and practice of ambulatory care are explored. The availability of time, the role of patient cooperation, and the decision-making process differ in the two settings. (MLW)

A total of 200 patients were interviewed at 2 out-patient settings to quantify the patients' perspectives on their illness by measuring their requests for help. Results showed specific requests were made by most patients that focused either on the problem and/or the treatment. (GLR)

Researchers in the Department of Bioengineering at Rice University are developing a new approach for fighting cancer, based on nanoshells that can both detect and destroy cancerous cells. The aim is to locate the cells, and be able to make a rational choice about whether they need to be destroyed and if possible they should immediately be sent for…

The outcome of a simulated clinical problem (drug-induced agranulocytosis) was compared with the outcome of similar cases in real medical service. The total performance of 100 sixth-year medical students at the end of their clerkship in internal medicine resulted in a mortality of 10 percent in the simulation exercise. (Editor/LBH)

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)

Self-care programs and information sources should serve as a catalyst to facilitate appropriate care seeking behavior in college students and improve communication with health professionals. Health professionals in self-care provide proper encouragement, skills, and resources to enable individuals to involve themselves in appropriate self-care…

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…