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J Physician Assist Educ. 2018 Dec;29(4):230-235. doi: 10.1097/JPA.0000000000000224.

Clinical Reasoning and Knowledge Organization: Bridging the Gap Between Medical Education and Neurocognitive Science.

Author information

1
Palma J. Longo, PhD, is an assistant professor in the Department of Health Care Sciences at the University of Texas Southwestern School of Health Professions, Dallas, Texas. Venetia L. Orcutt, PhD, is an associate professor in the Department of Physician Assistant Studies at the University of Texas Southwestern School of Health Professions, Dallas, Texas. Kassidy James, MHS, PA-C, is an assistant professor in the Department of Physician Assistant Studies at the University of Texas Southwestern School of Health Professions, Dallas, Texas. John Kane, MPAS, PA-C, is an assistant professor in the Department of Physician Assistant Studies at the University of Texas Southwestern School of Health Professions, Dallas, Texas. Veronica Coleman, MPAS, PA-C, is an assistant professor in the Department of Physician Assistant Studies at the University of Texas Southwestern School of Health Professions, Dallas, Texas.

Abstract

PURPOSE:

The purpose of this pilot study was 2-fold. The first was to investigate the conceptual relationship between previously validated methodologies. The second was to establish a linkage between medical education research and current neurocognitive science that accounts for knowledge organization during the clinical reasoning process.

METHODS:

Transcripts of Think Aloud interviews conducted after an objective structured clinical examination (n = 12) were coded and analyzed into 3 clinical reasoning competencies (semantic, diagnostic, and knowledge network organization). Correlational analyses were conducted to establish relationships between the 2 methodologies. Analyses of variance examined group differences.

RESULTS:

Significant correlations with large effect sizes were found between semantic, diagnostic, and knowledge network organization variables. Analysis of variance results approach significant difference in the knowledge network organization between weak versus strong diagnosticians.

CONCLUSIONS:

Knowledge network organization measurement can be used to discern differences in clinical reasoning and may offer explanations for the variation in health professionals' diagnostic performance.

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