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Problem-Solving Before Instruction (PS-I): A Protocol for Assessment and Intervention in Students with Different Abilities

Problem-Solving Before Instruction (PS-I): A Protocol for Assessment and Intervention in Students with Different Abilities

Published on: September 11, 2021

Exploring how students think: a new method combining think-aloud and concept mapping protocols.

Pierre Pottier¹, Jean-Benoit Hardouin¹, Brian D Hodges¹

¹Department of Internal Medicine, Nantes University Hospital Centre, Nantes, FranceTeam for Biostatistics (EA 4572), Department of Clinical Research and Subjective Measures in Health Science, University of Nantes, Nantes, FranceWilson Centre for Research in Education, University of Toronto, Toronto, Ontario, CanadaDepartment of Psychiatry, University of Toronto, Toronto, Ontario, Canada.

Medical Education

|August 19, 2010

Summary

This study introduces a reliable new method for assessing medical students' and experts' clinical reasoning styles. The technique quickly identifies inductive and deductive reasoning, aiding in the diagnosis of problem-solving skills.

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Area of Science:

Medical Education
Cognitive Science
Clinical Reasoning

Background:

Effective medical competence relies heavily on problem-solving abilities.
Physicians utilize inductive reasoning (facts to hypotheses) and deductive reasoning (hypotheses to confirmation).
A gap exists in methods to quantify inductive and deductive reasoning within clinical problem-solving assessments.

Purpose of the Study:

To explore the feasibility and reliability of a novel method for assessing clinical reasoning styles.
To rapidly identify inductive versus deductive reasoning patterns in medical students and experts.
To provide educators with a diagnostic tool for understanding student thought processes.

Main Methods:

Four participant groups (3rd, 4th, 5th-year medical students, and internal medicine specialists) were studied.
Participants verbalized their thought processes while solving clinical problems.
Thinking-aloud transcripts were converted into concept maps to distinguish inductive and deductive reasoning links.

Main Results:

Inter-writer reliability for concept map transcription was high (R = 0.66-0.93).
No significant differences in reasoning richness or exhaustiveness were found based on expertise level.
Experts exhibited a lower rate of inductive reasoning (41%) compared to students (67%), aligning with expectations.

Conclusions:

The developed method demonstrates good reliability for assessing clinical reasoning.
This tool offers a promising approach for evaluating medical problem-solving skills.
It provides valuable insights into how students and experts approach clinical challenges.