Clinical Reasoning and Knowledge Organization: Bridging the Gap Between Medical Education and Neurocognitive Science

J Physician Assist Educ. 2018 Dec;29(4):230-235. doi: 10.1097/JPA.0000000000000224.

Abstract

Purpose: The purpose of this pilot study was 2-fold. The first was to investigate the conceptual relationship between previously validated methodologies. The second was to establish a linkage between medical education research and current neurocognitive science that accounts for knowledge organization during the clinical reasoning process.

Methods: Transcripts of Think Aloud interviews conducted after an objective structured clinical examination (n = 12) were coded and analyzed into 3 clinical reasoning competencies (semantic, diagnostic, and knowledge network organization). Correlational analyses were conducted to establish relationships between the 2 methodologies. Analyses of variance examined group differences.

Results: Significant correlations with large effect sizes were found between semantic, diagnostic, and knowledge network organization variables. Analysis of variance results approach significant difference in the knowledge network organization between weak versus strong diagnosticians.

Conclusions: Knowledge network organization measurement can be used to discern differences in clinical reasoning and may offer explanations for the variation in health professionals' diagnostic performance.

MeSH terms

  • Clinical Competence
  • Clinical Decision-Making / methods*
  • Humans
  • Knowledge
  • Models, Educational*
  • Models, Psychological*
  • Physician Assistants / education*
  • Pilot Projects
  • Problem Solving