Assessing the Process of Clinical Problem Solving

This article describes a technique for the assessment of medical performances based on the sequence of questions (tactic) that physicians may ask in order to diagnose, treat or follow up a patient. The technique considers changes in the amount of information requested depending on: a) levels of medical experience, b) medical specialties, c) cultural environment, and d) individual diagnostic performance evaluated using different norms. The change in the information value (bits) of a given question depending on its ordinal placement in the tactic is discussed. The obtained results show that surgeons and clinicians request similar information but organize the diagnostic process differently, suggesting the possibility of applying the technique for early detection of specific vocations. The importance of the variable order is of crucial interest throughout all the described results. The obtained findings may serve to train medical students.