The development of clinical thinking in trainee physicians: the educator perspective.

Background: An important element of effective clinical practice is the way physicians think when they encounter a clinical situation, with a significant number of trainee physicians challenged by translating their learning into professional practice in the clinical setting. This research explores the perceptions of educators about how trainee physicians develop their clinical thinking in clinical settings. It considers what educators and their colleagues did to help, as well as the nature of the context in which they worked.

How Do Contexts Affect Physicians' Clinical Reasoning? A Narrative Review.

This article was migrated. The article was marked as recommended. Background Research about clinical reasoning has tended to focus on the individual, assessing their ability to perform clinical reasoning tasks.

Collaborative engagement with colleagues may provide better care for 'heart-sink' patients.

Introduction: In this article we show how a group of general practitioners' (GPs') professionalism was enhanced through collaborative engagement. Complexity, uncertainty and so-called 'heart-sink' patients are naturally embedded in clinical practice. GPs need to deal with, and even embrace, uncertainty, enabling them to provide patient-centred care.

The intensive training and assessment programme in histopathology.

A large number of experienced overseas graduates are attracted to the UK and form a significant proportion of applicants for training positions in histopathology. An individually tailored 3-month post can be used to evaluate the overseas doctor's abilities and assess his/her suitability for higher specialist training.

Self-management in diabetes: training implications for professional carers.

A workshop was convened to examine factors determining patient self-management and implications for those providing care. It was attended by 15 doctors and 15 nurses with considerable expertise in education for those with diabetes. Discussion included: the experience of training programmes to date; factors determining effective patient self-management; the implications for training of professionals, skills required, their current availability and proposals for their development.

Enhancing reliability in portfolio assessment: discussions between assessors.

This paper reports the reliability in assessments of a series of portfolios assembled by a cohort of participants attending a course for prospective general practice trainers. Initial individual assessments are compared with open discussion between random pairs of assessors to produce paired composite scores, and analysed using kappa statistics. Overall reliability of a global pass/refer judgement improved from a kappa of 0.

Enhancing reliability in portfolio assessment: 'shaping' the portfolio.

This paper reports a follow-on project that assessed a series of portfolios assembled by a cohort of participants attending a course for prospective general practice trainers. In an attempt to enhance reliability, a framework for defining and addressing problems using a reflective practice model was offered to participants. The reliability of the judgements made by a panel of assessors about individual 'components', together with an overall global judgement about performance were studied.

Developing professional judgment.

The concept of professional judgment is considered, including its theoretical foundations, how it is developed, and how it may be assessed. Professionals are asked to engage in complex and unpredictable tasks on society's behalf, and in doing so must exercise their discretion, making judgments--decide what is "best" in the particular situation rather than what is "right" in some absolute sense. Inevitably, some of these judgments lead to "error," which is endemic to professional practice.