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Record W2961947282 · doi:10.1080/0142159x.2019.1635686

The terminology of clinical reasoning in health professions education: Implications and considerations

2019· article· en· W2961947282 on OpenAlexaff
Meredith Young, Aliki Thomas, David Gordon, Larry D. Gruppen, Stuart Lubarsky, Joseph Rencic, Tiffany N.S. Ballard, Eric S. Holmboe, Ana da Silva, Temple Ratcliffe, Lambert Schuwirth, Steven J. Durning

Bibliographic record

VenueMedical Teacher · 2019
Typearticle
Languageen
FieldMedicine
TopicClinical Reasoning and Diagnostic Skills
Canadian institutionsMcGill UniversityCentre for Interdisciplinary Research in RehabilitationMcGill University Health Centre
Fundersnot available
KeywordsTerminologyVerbal reasoningCategorizationContext (archaeology)PsychologyAnalytic reasoningCoding (social sciences)Deductive reasoningMedical educationComputer scienceMedicineArtificial intelligenceLinguisticsCognitionSociology

Abstract

fetched live from OpenAlex

Introduction: Clinical reasoning is considered to be at the core of health practice. Here, we report on the diversity and inferred meanings of the terms used to refer to clinical reasoning and consider implications for teaching and assessment.Methods: In the context of a Best Evidence Medical Education (BEME) review of 625 papers drawn from 18 health professions, we identified 110 terms for clinical reasoning. We focus on iterative categorization of these terms across three phases of coding and considerations for how terminology influences educational practices.Results: Following iterative coding with 5 team members, consensus was possible for 74, majority coding was possible for 16, and full team disagreement existed for 20 terms. Categories of terms included: purpose/goal of reasoning, outcome of reasoning, reasoning performance, reasoning processes, reasoning skills, and context of reasoning.Discussion: Findings suggest that terms used in reference to clinical reasoning are non-synonymous, not uniformly understood, and the level of agreement differed across terms. If the language we use to describe, to teach, or to assess clinical reasoning is not similarly understood across clinical teachers, program directors, and learners, this could lead to confusion regarding what the educational or assessment targets are for “clinical reasoning.”

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.095
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.136
Threshold uncertainty score0.913

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.095
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.071
GPT teacher head0.475
Teacher spread0.404 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations86
Published2019
Admission routes1
Has abstractyes

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