Illness scripts describe the mental model used by experienced clinicians to store and recall condition-specific knowledge when making clinical decisions. Studies demonstrate that novice clinicians struggle to develop and apply strong illness scripts. We developed the Integrated Illness Script and Mechanism of Disease (IIS-MOD) map framework to address this challenge.
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http://dx.doi.org/10.1007/s40670-021-01293-z | DOI Listing |
J Gen Intern Med
January 2025
Department of Medicine, University of California San Francisco, San Francisco, USA.
Background: Many medical schools have incorporated clinical reasoning (CR) courses into their pre-clinical curricula to address the quality and safety issue of diagnostic error. It is unknown how students use concepts and practices from pre-clinical CR courses once in clerkships.
Objective: We sought to understand how students utilize CR concepts from a pre-clinical course during clerkships and to identify facilitators and barriers to the use of reasoning concepts.
PLoS One
January 2025
Academic Medicine Education Institute, Duke-NUS Medical School, Singapore, Singapore.
Introduction: Clinical medicine is becoming more complex and increasingly requires a team-based approach to deliver healthcare needs. This dispersion of cognitive reasoning across individuals, teams and systems (termed "distributed cognition") means that our understanding of cognitive biases and errors must expand beyond traditional "in-the-head" individual mental models and focus on a broader "out-in-the-world" context instead. To our knowledge, no qualitative studies thus far have examined cognitive biases in clinical settings from a team-based sociocultural perspective.
View Article and Find Full Text PDFNEJM Evid
January 2025
from the Neurology Residency and Vascular Neurology Fellowship Programs at the Miller School of Medicine, University of Miami.
Morning Report is a time-honored tradition where physicians-in-training present cases to their colleagues and clinical experts to collaboratively examine an interesting patient presentation. The Morning Report section seeks to carry on this tradition by presenting a patient's chief concern and story, inviting the reader to develop a differential diagnosis and discover the diagnosis alongside the authors of the case. This report examines the story of a 50-year-old man who presented for evaluation of weakness on the left side of his body and difficulty speaking clearly.
View Article and Find Full Text PDFPurpose: Despite universal agreement on the importance of clinical reasoning skills, inadequate curricular attention to these skills remains a problem. To facilitate integration of clinical reasoning instruction and assessment into the preclerkship phase, the authors created a clinical reasoning curriculum using technology-enhanced patient simulations.
Method: In 2023, first-year medical students at Duke University School of Medicine were enrolled in a biomedical science course using diagnostic reasoning sessions and 16 virtual, interactive patient (VIP) encounters to teach and assess clinical reasoning.
Indian J Palliat Care
October 2024
Department of Surgical Oncology, Malabar Cancer Centre, Kannur, Kerala, India.
Objective: The objective of this study was to validate the 'Functional Assessment of Chronic Illness Therapy-Spiritual-Well-being-Expanded(FACIT-SpEx) Version 4' tool in Malayalam and assess its feasibility among advanced cancer patients receiving palliative care.
Materials And Methods: The study was carried out at the outpatient Department of Cancer Palliative Medicine of Malabar Cancer Centre between November 2022 and June 2023. Initially, the FACIT-Sp-Ex version 4 tool with 23 items was translated into the Malayalam language with a forward-backward translation procedure.
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