The patient problem list and clinical reasoning : linking education to practice
Bibliographic record
Abstract
4L'auteur a accord une licence non exclusive permettant la Bibliothque et Archives Canada de reproduire, publier, archiver, sauvegarder, conserver, transmettre au public par tlcommunication ou par l'Internet, prter, distribuer et vendre des thses partout dans le monde, des fins commerciales ou autres, sur support microforme, papier, lectronique et/ou autres formats.L'auteur conserve la proprit du droit d'auteur et des droits moraux qui protge cette thse.Ni la thse ni des extraits substantiels de celle-ci ne doivent tre imprims ou autrement reproduits sans son autorisation.Conformment la loi canadienne sur la protection de la vie prive, quelques formulaires secondaires ont t enlevs de cette thse.Bien que ces formulaires aient inclus dans la pagination, il n'y aura aucun contenu manquant.The Patient Problem List and Clinical Reasoning ABSTRACT This study examined how medical tutors used a tool from clinical practice known as the patient problem list to support students' clinical reasoning in a natural internaI medicine ward setting.A grounded 2 case comparative study was conducted with 2 real patient case discussions by a tutor and 3 pre-clerkship students and a resident and 1 clerkship level student respectively.Codes that emerged by verbal analysis of the data were related to each other in a discourse map.In both cases evidence of cognitive apprenticeship teaching strategies and the patient problem list shaped and were shaped by a spiral model of increasingly elaborate shared knowledge.The patient problem list links tutor support to student education for practice with complex medical patients.The Patient Problem List and Clinical Reasoning 11 RSUM Cette tude a observ comment les enseignants en mdicine utilisent un outil de la pratique clinique, la liste des problmes du patient, pour favoriser le raisonnement clinique des tudiants en mdecine interne dans un contexte naturel.Une tude de cas analyse selon la mthode de la thorisation ancre (thorie fonde sure les donnes) a t faite sur 2 prsentations du cas de vraies malades hospitalises.Un des cas fut discut entre le prcepteur et 3 tudiants en stage pr clinique et l'autre entre 1 rsident et 1 tudiant en stage clinique.Les codes qui ont mergs de l'analyse ont ts compars dans une structure de representation visuelle du discours.Dans chaqun des cas l'emploi des stratgies d'enseignement suivant le modle d'apprentisage cognitif et de la liste des problmes du patient a pris la forme d'un modle spiral de connaissances partages itratives.La liste des problmes du malade sert de liaison entre le soutien pdagogique et la formation des tudiants en raisonnement clinique pratique avec des cas de malades complexes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
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".