ERIC Number: ED050164
Record Type: RIE
Publication Date: 1971-Feb
Reference Count: 0
A Method for the Study of Medical Thinking and Problem Solving.
Elstein, Arthur S.; Shulman, Lee S.
A method for studying medical reasoning in a life-like setting is reported. Simulated medical problems, amplified by concurrent thinking aloud, episodic retrospection during the work-up, and videotape-stimulated retrospection, are used to obtain records of the behavior and reasoning physicians use to solve diagnostic problems. The fundamental units of analysis are questions, critical findings, and hypotheses. Eight categories of questions relate the information seeking behavior of the inquiring physician to a widely accepted outline for medical history taking. Critical findings in a case are elicited by questions and are assigned weights depending upon their relation to any conceivable diagnostic hypothesis. Hypotheses tested by an inquirer are identified from his thinking aloud and retrospection. Findings elicited are evaluated in relation to inquirer's hypotheses or to those he might have considered but did not. Medical diagnosis is thus analyzed as a special case of hypothesis testing. The method is illustrated by application to two work-ups of the same problem; one globally rated substantially better than the other. The method effectively distinguishes between the two in psychologically relevant ways. Discussion relates the findings to current work in problem solving. (Author)
Descriptors: Clinical Diagnosis, Cognitive Measurement, Critical Thinking, Data Analysis, Decision Making Skills, Hypothesis Testing, Medical Education, Medical Evaluation, Physicians, Problem Solving, Rating Scales, Research Design, Scientific Attitudes, Scientific Methodology, Simulation, Videotape Recordings
Publication Type: N/A
Education Level: N/A
Authoring Institution: Michigan State Univ., East Lansing.
Note: Paper presented at the Annual Meeting of the American Educational Research Association, New York, New York, February 1971