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Problem-Solving Before Instruction PS-I: A Protocol for Assessment and Intervention in Students with Different Abilities
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Characteristics differentiating problem representation synthesis between novices and experts.
Casey N McQuade1, Michael G Simonson1, Julia Lister2,3
1Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Journal of Hospital Medicine
|March 26, 2024
Summary
Expert problem representations (PRs) synthesize clinical data into higher-order concepts and exclude irrelevant information. This study identified key differences in PRs between novice and expert clinicians, offering insights for medical education.
Area of Science:
- Medical Education
- Clinical Reasoning
- Health Professions Education
Background:
- Problem representation (PR) is crucial for clinical reasoning and medical education.
- Consensus on high-quality PR characteristics is lacking.
- Distinguishing expert from novice PRs can inform educational strategies.
Purpose of the Study:
- To identify characteristics differentiating problem representations (PRs) created by expert and novice clinicians.
- To explore the relationship between PR characteristics and diagnostic accuracy.
Main Methods:
- Comparative analysis of PRs from internal medicine residents (novices) and faculty (experts) using clinical vignettes.
- Deductive content analysis to identify and quantify PR characteristics.
- Mixed-effects regression modeling to compare groups and correlate PRs with diagnostic accuracy.
Main Results:
- Experts included fewer irrelevant comorbidities and diagnoses than novices.
- Experts synthesized clinical data into higher-order concepts more effectively.
- PRs with a three-part structure and temporal semantic qualifiers correlated with diagnostic accuracy.
Conclusions:
- Expert problem representations (PRs) are characterized by concise, synthesized information and exclusion of irrelevant data.
- Findings suggest potential for educational interventions to improve PR quality and diagnostic accuracy.
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