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Titulo Artículo:
Contextual factors and clinical reasoning: differences in diagnostic and therapeutic reasoning in board certified versus resident physicians
Resumen:
Background The impact of context on the complex process of clinical reasoning is not well understood. Using situated cognition as the theoretical framework and videos to provide the same contextual “stimulus” to all participants, we examined the relationship between specific contextual factors on diagnostic and therapeutic reasoning accuracy in board certified internists versus resident physicians. Methods Each participant viewed three videotaped clinical encounters portraying common diagnoses in internal medicine. We explicitly modified the context to assess its impact on performance (patient and physician contextual factors). Patient contextual factors, including English as a second language and emotional volatility, were portrayed in the videos. Physician participant contextual factors were self-rated sleepiness and burnout.. The accuracy of diagnostic and therapeutic reasoning was compared with covariates using Fisher Exact, Mann-Whitney U tests and Spearman Rho’s correlations as appropriate. Results Fifteen board certified internists and 10 resident physicians participated from 2013 to 2014. Accuracy of diagnostic and therapeutic reasoning did not differ between groups despite residents reporting significantly higher rates of sleepiness (mean rank 20.45 vs 8.03, U = 0.5, p < .001) and burnout (mean rank 20.50 vs 8.00, U = 0.0, p < .001). Accuracy of diagnosis and treatment were uncorrelated (r = 0.17, p = .65). In both groups, the proportion scoring correct responses for treatment was higher than the proportion scoring correct responses for diagnosis.
Fecha de publicación:
2017.
Autores :
Temple Ratcliffe;
Katherine Picho;
ambert Schuwirth;
Anthony R. Artino, Jr.;
Ana Monica Yepes-Rios;
Jennifer Masel;
Cees van der Vleuten;
Steven J. Durning;
Elexis McBee;
Autor corporativo:
BMC medical education,
Editores:
Medline-PubMed ;
Signatura Topográfica:
211
Idioma:
Inglés
Páginas:
1
ISBN:
1472-6920
Existencias:
8
Palabras claves:
Clinical reasoning
Medical Education
Situated Cognition
Quantitative Methods
Público objetivo:
Docentes
Medicos
Investigadores
Educadores Medicos
Titulo Artículo:
Contextual factors and clinical reasoning: differences in diagnostic and therapeutic reasoning in board certified versus resident physicians
Resumen:
Background The impact of context on the complex process of clinical reasoning is not well understood. Using situated cognition as the theoretical framework and videos to provide the same contextual “stimulus” to all participants, we examined the relationship between specific contextual factors on diagnostic and therapeutic reasoning accuracy in board certified internists versus resident physicians. Methods Each participant viewed three videotaped clinical encounters portraying common diagnoses in internal medicine. We explicitly modified the context to assess its impact on performance (patient and physician contextual factors). Patient contextual factors, including English as a second language and emotional volatility, were portrayed in the videos. Physician participant contextual factors were self-rated sleepiness and burnout.. The accuracy of diagnostic and therapeutic reasoning was compared with covariates using Fisher Exact, Mann-Whitney U tests and Spearman Rho’s correlations as appropriate. Results Fifteen board certified internists and 10 resident physicians participated from 2013 to 2014. Accuracy of diagnostic and therapeutic reasoning did not differ between groups despite residents reporting significantly higher rates of sleepiness (mean rank 20.45 vs 8.03, U = 0.5, p < .001) and burnout (mean rank 20.50 vs 8.00, U = 0.0, p < .001). Accuracy of diagnosis and treatment were uncorrelated (r = 0.17, p = .65). In both groups, the proportion scoring correct responses for treatment was higher than the proportion scoring correct responses for diagnosis.
Fecha de publicación:
2017.
Autores :
Temple Ratcliffe;
Katherine Picho;
ambert Schuwirth;
Anthony R. Artino, Jr.;
Ana Monica Yepes-Rios;
Jennifer Masel;
Cees van der Vleuten;
Steven J. Durning;
Elexis McBee;
Autor corporativo:
BMC medical education,
Editores:
Medline-PubMed ;
Signatura Topográfica:
211
Idioma:
Inglés
Páginas:
1
Existencias:
8
Palabras claves:
Clinical reasoning
Medical Education
Situated Cognition
Quantitative Methods
Público objetivo:
Docentes
Medicos
Investigadores
Educadores Medicos
Titulo Artículo:
Contextual factors and clinical reasoning: differences in diagnostic and therapeutic reasoning in board certified versus resident physicians
Resumen:
Background The impact of context on the complex process of clinical reasoning is not well understood. Using situated cognition as the theoretical framework and videos to provide the same contextual “stimulus” to all participants, we examined the relationship between specific contextual factors on diagnostic and therapeutic reasoning accuracy in board certified internists versus resident physicians. Methods Each participant viewed three videotaped clinical encounters portraying common diagnoses in internal medicine. We explicitly modified the context to assess its impact on performance (patient and physician contextual factors). Patient contextual factors, including English as a second language and emotional volatility, were portrayed in the videos. Physician participant contextual factors were self-rated sleepiness and burnout.. The accuracy of diagnostic and therapeutic reasoning was compared with covariates using Fisher Exact, Mann-Whitney U tests and Spearman Rho’s correlations as appropriate. Results Fifteen board certified internists and 10 resident physicians participated from 2013 to 2014. Accuracy of diagnostic and therapeutic reasoning did not differ between groups despite residents reporting significantly higher rates of sleepiness (mean rank 20.45 vs 8.03, U = 0.5, p < .001) and burnout (mean rank 20.50 vs 8.00, U = 0.0, p < .001). Accuracy of diagnosis and treatment were uncorrelated (r = 0.17, p = .65). In both groups, the proportion scoring correct responses for treatment was higher than the proportion scoring correct responses for diagnosis.
Autores:
Temple Ratcliffe
,
Katherine Picho
,
ambert Schuwirth
,
Anthony R. Artino, Jr.
,
Ana Monica Yepes-Rios
,
Jennifer Masel
,
Cees van der Vleuten
,
Steven J. Durning
,
Elexis McBee
,
.
Titulo Revista:
BMC medical education,
.
Numero:
211
Volumen:
17
Fecha de publicación:
2017.
Base de Datos Bibliográfica:
Medline-PubMed ,
.
Suplemento:
Idioma:
Inglés
Página Inicial:
1
Página Final:
8
ISBN:
1472-6920
Palabras claves:
Clinical reasoning
Medical Education
Situated Cognition
Quantitative Methods
Público objetivo:
Docentes
Medicos
Investigadores
Educadores Medicos
Título Medline-PubMed :
Contextual factors and clinical reasoning: differences in diagnostic and therapeutic reasoning in board certified versus resident physicians
Resumen:
Background The impact of context on the complex process of clinical reasoning is not well understood. Using situated cognition as the theoretical framework and videos to provide the same contextual “stimulus” to all participants, we examined the relationship between specific contextual factors on diagnostic and therapeutic reasoning accuracy in board certified internists versus resident physicians. Methods Each participant viewed three videotaped clinical encounters portraying common diagnoses in internal medicine. We explicitly modified the context to assess its impact on performance (patient and physician contextual factors). Patient contextual factors, including English as a second language and emotional volatility, were portrayed in the videos. Physician participant contextual factors were self-rated sleepiness and burnout.. The accuracy of diagnostic and therapeutic reasoning was compared with covariates using Fisher Exact, Mann-Whitney U tests and Spearman Rho’s correlations as appropriate. Results Fifteen board certified internists and 10 resident physicians participated from 2013 to 2014. Accuracy of diagnostic and therapeutic reasoning did not differ between groups despite residents reporting significantly higher rates of sleepiness (mean rank 20.45 vs 8.03, U = 0.5, p < .001) and burnout (mean rank 20.50 vs 8.00, U = 0.0, p < .001). Accuracy of diagnosis and treatment were uncorrelated (r = 0.17, p = .65). In both groups, the proportion scoring correct responses for treatment was higher than the proportion scoring correct responses for diagnosis.
Autores :
Temple Ratcliffe;
Katherine Picho;
ambert Schuwirth;
Anthony R. Artino, Jr.;
Ana Monica Yepes-Rios;
Jennifer Masel;
Cees van der Vleuten;
Steven J. Durning;
Elexis McBee;
Autor corporativo:
BMC medical education,
Fecha de publicación:
2017.
Tipo :
Medline-PubMed .
Idioma:
Inglés
Palabras claves:
Clinical reasoning
Medical Education
Situated Cognition
Quantitative Methods
Público objetivo:
Docentes
Medicos
Investigadores
Educadores Medicos
Título Medline-PubMed :
Contextual factors and clinical reasoning: differences in diagnostic and therapeutic reasoning in board certified versus resident physicians
Resumen:
Background The impact of context on the complex process of clinical reasoning is not well understood. Using situated cognition as the theoretical framework and videos to provide the same contextual “stimulus” to all participants, we examined the relationship between specific contextual factors on diagnostic and therapeutic reasoning accuracy in board certified internists versus resident physicians. Methods Each participant viewed three videotaped clinical encounters portraying common diagnoses in internal medicine. We explicitly modified the context to assess its impact on performance (patient and physician contextual factors). Patient contextual factors, including English as a second language and emotional volatility, were portrayed in the videos. Physician participant contextual factors were self-rated sleepiness and burnout.. The accuracy of diagnostic and therapeutic reasoning was compared with covariates using Fisher Exact, Mann-Whitney U tests and Spearman Rho’s correlations as appropriate. Results Fifteen board certified internists and 10 resident physicians participated from 2013 to 2014. Accuracy of diagnostic and therapeutic reasoning did not differ between groups despite residents reporting significantly higher rates of sleepiness (mean rank 20.45 vs 8.03, U = 0.5, p < .001) and burnout (mean rank 20.50 vs 8.00, U = 0.0, p < .001). Accuracy of diagnosis and treatment were uncorrelated (r = 0.17, p = .65). In both groups, the proportion scoring correct responses for treatment was higher than the proportion scoring correct responses for diagnosis.
Autores :
Temple Ratcliffe;
Katherine Picho;
ambert Schuwirth;
Anthony R. Artino, Jr.;
Ana Monica Yepes-Rios;
Jennifer Masel;
Cees van der Vleuten;
Steven J. Durning;
Elexis McBee;
Autor corporativo:
BMC medical education,
Fecha de publicación:
2017.
Paginas:
1.
ISBN:
1472-6920.
Idioma:
Inglés
Palabras claves:
Clinical reasoning
Medical Education
Situated Cognition
Quantitative Methods
Público objetivo:
Docentes
Medicos
Investigadores
Educadores Medicos
Titulo Artículo:
Contextual factors and clinical reasoning: differences in diagnostic and therapeutic reasoning in board certified versus resident physicians
Resumen:
Background The impact of context on the complex process of clinical reasoning is not well understood. Using situated cognition as the theoretical framework and videos to provide the same contextual “stimulus” to all participants, we examined the relationship between specific contextual factors on diagnostic and therapeutic reasoning accuracy in board certified internists versus resident physicians. Methods Each participant viewed three videotaped clinical encounters portraying common diagnoses in internal medicine. We explicitly modified the context to assess its impact on performance (patient and physician contextual factors). Patient contextual factors, including English as a second language and emotional volatility, were portrayed in the videos. Physician participant contextual factors were self-rated sleepiness and burnout.. The accuracy of diagnostic and therapeutic reasoning was compared with covariates using Fisher Exact, Mann-Whitney U tests and Spearman Rho’s correlations as appropriate. Results Fifteen board certified internists and 10 resident physicians participated from 2013 to 2014. Accuracy of diagnostic and therapeutic reasoning did not differ between groups despite residents reporting significantly higher rates of sleepiness (mean rank 20.45 vs 8.03, U = 0.5, p < .001) and burnout (mean rank 20.50 vs 8.00, U = 0.0, p < .001). Accuracy of diagnosis and treatment were uncorrelated (r = 0.17, p = .65). In both groups, the proportion scoring correct responses for treatment was higher than the proportion scoring correct responses for diagnosis.
Fecha de publicación:
2017.
Autor corporativo:
BMC medical education,
.
Idioma:
Inglés
Palabras claves:
Clinical reasoning
Medical Education
Situated Cognition
Quantitative Methods
Público objetivo:
Docentes
Medicos
Investigadores
Educadores Medicos
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Temple Ratcliffe Katherine Picho ambert Schuwirth Anthony R. Artino, Jr. Ana Monica Yepes-Rios Jennifer Masel Cees van der Vleuten Steven J. Durning Elexis McBee Temple Ratcliffe Katherine Picho ambert Schuwirth Anthony R. Artino, Jr. Ana Monica Yepes-Rios Jennifer Masel Cees van der Vleuten Steven J. Durning Elexis McBee Contextual factors and clinical reasoning: differences in diagnostic and therapeutic reasoning in board certified versus resident physicians. 2017; 17Ed. 1.
