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Does management reasoning constitute the backbone of the clinical learning environment?: Conceptual analysis of the existing notions | ||
Journal of Advances in Medical Education & Professionalism | ||
دوره 9، شماره 1، فروردین 2021، صفحه 54-58 اصل مقاله (460.29 K) | ||
نوع مقاله: Commentary | ||
شناسه دیجیتال (DOI): 10.30476/jamp.2020.84431.1138 | ||
نویسندگان | ||
DINESH KUMAR V* 1؛ ANEESH BASHEER2 | ||
1Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India; | ||
2Department of Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India | ||
چکیده | ||
Management reasoning is a paradigm whereby learning occurs in a context bound fashion on analysing the biophysical factors existing in the clinical learning environment. In the contemporary medical education forums, much importance is being laid on clinical reasoning and this warrants the appropriate usage of the biomedical knowledge in arriving at the diagnosis. We perceive that clinical reasoning, in pure sense, often doesn’t solve the purpose of rendering the best management plan to the patient. This holds stronger when the case is non-linear and highly complex in nature. Management reasoning fills the gap between hypotheses generation, i.e. accomplishing diagnosis and devising management plan. Indeed, it is a complex activity relying on several factors including the physician’s perceptual abilities and situated cognition derived from formal and informal learning experiences. In contrast to clinical reasoning, which can be taught using structured scenarios, management reasoning necessitates analysing multitude of factors revolving around a patient and prioritizing those in order to titrate the best possible management plan. This commentary spotlights different dimensions of management reasoning, emphasizes the need of teaching it in the current scenarios, enlists the ways it can be taught, and opens the platform for discussing further on this underemphasized topic. | ||
کلیدواژهها | ||
Clinical reasoning؛ Decision making؛ Social determinants | ||
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مراجع | ||
1. Gruppen L, Irby MD, Durning SJ, Maggio LA. Interventions designed to improve the learning environment in the health professions: a scoping review. AMEE MedEd Pub. 2018; 7:73. 2. Kilty C, Flood P, Fu N, Horgan M, Higgins A, Bridget M, et al. A national stakeholder consensus study of challenges and priorities for clinical learning environments in postgraduate medical education. BMC Med Educ. 2017; 17: 226. 3. Josiah M. Jr. Foundation. Improving environments for learning in the health professions. Recommendations from the Macy Foundation Conference. New York: Josiah Macy Jr. Foundation; 2018. 4. Patel JJ, Bergl PA. Diagnostic vs Management Reasoning. JAMA. 2018; 320(17): 1818. 5. Goldszmidt M, Minda JP, Bordage G. Developing a unified list of physicians’ reasoning tasks during clinical encounters. Acad Med. 2013; 88: 390–7. 6. Groopman J, Hartzband P. Thinking about our thinking as physicians [Internet]. ACP Internist; 2011. [Accessed June 6, 2019]. Available from: http://www.acpinternist. org/archives/2011/10/mindful.htm. 7. Resnik L, Jensen GM. Using clinical outcomes to explore the theory of expert practice in physical therapy. Physical Therapy. 2003; 83: 1090–106. 8. Weiner SJ, Schwartz A. Contextual Errors in Medical Decision Making: Overlooked and Understudied. Acad Med. 2016; 91(5): 657–62. 9. Durning S, Artino A, Pangaro L, van der Vleuten C, Schuwirth L. Redefining context in the clinical encounter: implications for research and training in medical education. Acad Med. 2010;85(5):890–4. 10. Weiner SJ, Kelly B, Ashley N, Binns-Calvey A, Sharma G, Schwartz A, et al. Content coding for contextualization of care: Evaluating physician performance at patient centred decision making. Med Decis Making. 2014; 34:97–106. 11. Weiner SJ, Schwartz A, Yudkowsky R, Schiff GD, Weaver FM, Goldberg J, et al. Evaluating physician performance at individualizing care: A pilot study tracking contextual errors in medical decision making. Med Decis Making. 2007; 27:726-34. 12. Durning SJ, Artino AR Jr, Schuwirth L, van der Vleuten C. Clarifying assumptions to enhance our understanding and assessment of clinical reasoning. Acad Med. 2013; 88: 442-8. 13. Durning SJ, Artino AR. Situativity theory: A perspective on how participants and the environment can interact. Med Teach. 2011; 33:188–99. 14. Gutkin TB. Ecological Psychology: Replacing the Medical Model Paradigm for School-Based Psychological and Psycho-educational Services. Journal of Educational and Psychological Consultation. 2012; 22(1-2): 1–20. 15. Durning SJ, Artino AR, Boulet JR, Dorrance K, van der Vleuten C, Schuwirth L. The impact of selected contextual factors on experts’ clinical reasoning performance (does context impact clinical reasoning performance in experts?). Advances in Health Sciences Education. 2011;17(1):65–79. 16. van Merrienboer JJG, Sweller J. Cognitive load theory in health professional education: Design principles and strategies. Med Educ 2010; 44: 85–93. 17. Paas F, Renkl A, Sweller J. Cognitive load theory and instructional design: Recent developments. Educational Psychologist. 2003; 38: 1–4. 18. Monajemi A, Rikers RMJP, Schmidt HG. Clinical case processing: A diagnostic versus a management focus. Med Educ. 2007; 41: 1166–72. 19. Evans JS. In two minds: dual-process accounts of reasoning. Trends Cogn Sci. 2003; 7(10):454–9. 20. Evans St BT. Spot the difference: distinguishing between two kinds of processing. Mind Soc. 2012; 11(1):121–31. 21. Eva KW. What every teacher needs to know about clinical reasoning. Med Educ. 2005; 39: 98-106. 22. Linn A, Khaw C, Kildea H, Tonkin A. Clinical reasoning - a guide to improving teaching and practice. Aust Fam Physician. 2012; 41:18-20. 23. Rikers RMJP, Schmidt HG, Boshuizen HPA, Linssen GC, Wesseling G, Paas FG. The robustness of medical expertise: clinical case processing by medical experts and sub-experts. Am J Psychol. 2002; 115(4):609–29. 24. Cook DA, Durning SJ, Sherbino J, Gruppen LD. Management Reasoning: Implications for Health Professions Educators and a Research Agenda. Acad Med. 2019;94(9):1310-6. | ||
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