Describes a new approach to clinical reasoning education called clinical reasoning theater (CRT). With students as the audience, the doctor's clinical reasoning skills are modeled in CRT when he or she thinks aloud during conversations with the patient. Preliminary results of students' evaluations of the relevance of CRT reveal that they…

Discusses three caveats to the evidence-based paradigm in medical education: (1) detection of abnormalities that may not ever be overtly expressed inflates apparent diagnostic test performance; (2) probability revision is valuable primarily as an exercise to gain qualitative insights; and (3) patients are likely to be interested in more than just…

Assessed students' competence in addressing the health beliefs and cultural concerns of a standardized patient, an African American woman with diabetes, during a clinical interview. Found that minority students displayed greater competence in addressing the patient's concerns about altering culturally-based dietary behaviors; white students…

The study examined how 3 medical information-gathering processes (history-taking, physical examination, and diagnostic studies) influenced 175 second-year medical students' formulations of the differential and the principal diagnoses of 14 simulated patient management problems in comparison with experienced clinicians. Students emphasized…

Describes an electronic database of clinical questions (CQs) and medical evidence, the Critical Appraisal Resource (CAR). Evaluation of ten months of use found that medical residents did engage the medical literature on behalf of their patients, which influenced approximately half of their patient-care decisions. (EV)

The article describes an elective course, part of the required psychiatry clerkship, at Dartmouth Medical School (New Hampshire), which stresses development of critical thinking skills in the diagnosis and management of patients with substance abuse and related medical and psychiatric complications. (Author/DB)

A group of medical students at Wright State University School of Medicine developed and participated in a one-month elective on selecting and interpreting diagnostic tests. Tests and diseases were reviewed, recorded and published by the students as a reference manual for their later use during clinical rotations. (MLW)

A 1990 study of domain-referenced scores from a multiple-station clinical examination for foreign medical graduates investigated identification of essential checklist items, setting of minimum passing scores, consistency of candidate classification, and perceived appropriateness of the number of candidates classified as competent. Results and…

Responses to questionnaires were compared between 106 students in nursing homes with those of 171 students in hospitals to evaluate interview and physical examination instruction for medical students. The nursing home was assessed as an appropriate alternative site for teaching the medical interview and physical diagnosis. (GLR)

A one-month, elective fourth-year medical school course in advanced physical diagnosis is described. The course featured organ-specific didactic and interactive practice sessions, physical examination-based case conferences, professorial rounds with use of professional patients, and objective structured clinical examinations. (Author/MSE)

The patient's body is an image that medical students and residents use to process information. The classic use of images using the patient is qualitative and personal. The contemporary use of images is quantitative and impersonal. The contemporary use of imaging includes radiographic, nuclear, scintigraphic, and nuclear magnetic resonance…

Medical students (N=284) from four Northeastern medical schools interacted with standardized patients, then were given a free-response form (blank form for writing diagnostic impressions) and then they completed a cued-response form, which listed a series of diagnoses generated by the case author. The patients also completed a checklist. (MLW)

A study of medical students' and internal medicine course directors' perceptions of the value of medical case write-ups and the faculty evaluations of those write-ups found broad agreement on the exercise's value but major concerns about variability of criteria and standards of write-up evaluation. (MSE)

At the end of their clinical clerkship rotations, all students in one medical school's classes of 1988 (N=69), 1989 (N=63), 1990 (N=66) took the Post-Clerkship Examination. This study examined the nature of the patients' satisfaction ratings; reliability of patient satisfaction ratings and number of patients needed to derive reliable ratings; etc.…

Medical schools (N=136) were surveyed concerning their use of standardized patients (lay persons trained to replicate a clinical encounter consistently and realistically). Among 16 specific topics covered are breast and pelvic examination, male genitourinary examination, interviewing skills, administration of program, start-up concerns, and…