Clinical teachers differ from clinicians in a fundamental way.They must simultaneously foster high-quality patient care andassess the clinical skills and reasoning of learners in orderto promote their progress toward independence in the clinicalsetting.1 Clinical teachers must diagnose both the patient'sclinical problem and the learner's ability and skill.
To assess a learner's diagnostic reasoning strategies effectively,the teacher needs to consider how doctors learn to reason inthe clinical environment.2,3,4 Medical students in a classroomgenerally organize medical knowledge according to the structureof the curriculum. For example, if pathophysiology is taughtaccording to organ systems, . . . [Full Text of this Article]
Diagnostic Reasoning
Recommendations for Clinical Teachers
Articulating Problem Representations
Strategies for Comparing and Contrasting
Varying Expectations According to Developmental Level
Providing Cognitive Feedback
Encouraging Useful Reading Habits
Source Information
From the Department of Medicine, Oregon Health and Science University, Portland.
Address reprint requests to Dr. Bowen at the Department of Medicine, 3181 S.W. Sam Jackson Park Rd., L-475, Portland, OR 97239, or at bowenj@ohsu.edu.
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Clinical Diagnostic Reasoning
Levy P. D., Sherwin R. L., Kuhn G. J., McColl G. J., Groves M. A., Echols M. R., Garman K. S., Lyles K. W., Marsh E., Sorisky A., Grossman P. D., Rodríguez M. A., Bowen J. L.
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N Engl J Med 2007;
356:1272-1274, Mar 22, 2007.
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