Most first- and fourth-year medical students in one school were unable to solve a written problem case, suggesting that medical education has failed to teach the skills of formulating overall hypotheses and subhypotheses before choosing treatment options. (Author/MSE)

One third-year clinical clerkship in pediatrics has included Sherlock Holmes mysteries in its introductory curriculum, providing students with a model clinical problem-solving process and a list of issues on which they will need information. The nonclinical cases provide an effective and entertaining vehicle for learning clinical reasoning. (MSE)

A successful approach to improving a residency training program in internal medicine had residents, attending physicians, and administrators use a consensus-building method to develop problem lists ranked by two criteria (high importance and high potential for solution), for which short- and long-term management interventions were created. (MSE)

Computer-based problem-solving examinations in immunology generate graphic representations of students' search paths, allowing evaluation of how organized and focused their knowledge is, how well their organization relates to critical concepts in immunology, where major misconceptions exist, and whether proper knowledge links exist between content…

A study to determine the feasibility of creating and administering computer-based problem-solving examinations for evaluating second-year medical students in immunology and to determine how students would perform on these tests relative to their performances on concurrently administered objective and essay examinations is described. (Author/MLW)

A study in which 92 second-year medical students wrote essays on ethical dilemmas found most students were familiar with major ethical theories and principles currently in use and able to apply them appropriately. Gender differences were found in choice of topic, ethical principles used, and level of personal orientation. (Author/MSE)

Discusses clinical problem analysis (CPA) in medical education, an approach to solving complex clinical problems. Outlines the five step CPA model and examines the value of CPA's content-independent (methodical) approach. Argues that teaching students to use CPA will enable them to avoid common diagnostic reasoning errors and pitfalls. Compares…

A study investigated student use of a collection of self-directed anatomy learning modules designed to help students prepare for tutorial discussions of health care problems. The surveyed students (n=80) reported that module use depended on program level and premedical background in biology, not on tutor or preceptor requirements. Students who…

Research reveals that successful problem solvers must possess comprehensive knowledge, and more importantly, have appropriate knowledge organization and understanding. A new taxonomy of medical problems is recommended, and it is suggested that the traditional hypothetico-deductive strategy for problem-based learning be replaced by scheme-driven…

Field testing of a series of group-learning units in pharmacology based on a patient-oriented problem-solving approach found that the units were well crafted and that students had higher scores on tests of their knowledge of pharmacology after they had used the units. (Author/DB)

Computer-based clinical simulations used in medical education are designed according to decisions about which elements of reality to explicitly include, which to leave to imagination, and when to intervene for educational purposes. Programs offer many options for structuring the simulations, such as varying levels of volunteered information about…

It is proposed that, contrary to existing views, medical expertise is not as much a matter of superior reasoning skills or in-depth knowledge of pathophysiological states as it is based on cognitive structures describing the features of prototypical or actual patients. Evidence supporting the theory is examined. (Author/MSE)

Students in a problem-oriented alternative medical curriculum at Michigan State University used the same problem-based methods for curriculum improvement that are used to solve clinical problems. Students worked with faculty toward constructive curricular revision. (MSE)

An approach to testing medical students' clinical decision-making skills identifies key features (critical steps in resolution of a clinical problem) and presents a clinical case scenario followed by questions focusing on those key features. Key-feature problems provide flexibility on issues of question format, multiple responses to questions, and…

The University of Illinois' medical school has a third-year program of weekly role-playing exercises focusing on management of acute medical problems. Students are responsible for creating the cases, complete with scenarios and treatment teams, simulating them, and successfully treating or reaching an impasse. Little teacher preparation time is…