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dc.contributor.authorLopes,Djon Machado
dc.contributor.authorBregagnollo,Gustavo Henrique
dc.contributor.authorBarbosa,Bruna Morais
dc.contributor.authorStamm,Ana Maria Nunes de Faria
dc.date.accessioned2019-09-23T12:52:48Z
dc.date.available2019-09-23T12:52:48Z
dc.date.created2018-12-29 00:35
dc.date.issued2018-01-01
dc.identifieroai:scielo:S0100-55022018000100115
dc.identifierhttp://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-55022018000100115
dc.identifier.urihttp://hdl.handle.net/20.500.12424/8570
dc.description.abstractABSTRACT Introduction: Research in the field of medical reasoning has shed light on the reasoning process used by medical students. The strategies in this process are related to the analytical [hypothetical-deductive (HD)] and nonanalytic [scheme-inductive) (SI)] systems, and pattern recognition (PR)]. Objective: To explore the clinical reasoning process of students from the fifth year of medical school at the end of the clinical cycle of medical internship, and to identify the strategies used in preparing diagnostic hypotheses, knowledge organization and content. Method: Qualitative research conducted in 2014 at a Brazilian public university with medical interns. Following Stamm's method, a case in internal medicine (IM) was built based on the theory of prototypes (Group 1 = 47 interns), in which the interns listed, according to their own perceptions, the signs, symptoms, syndromes, and diseases typical of internal medicine. This case was used for evaluating the clinical reasoning process of Group 2 (30 students = simple random sample) obtained with the "think aloud" process. The verbalizations were transcribed and evaluated by Bardin's thematic analysis. The content analysis were approved by two experts at the beginning and at the end of the analysis process. Results: The interns developed 164 primary and secondary hypotheses when solving the case. The SI strategy prevailed with 48.8%, followed by PR (35.4%), HD (12.2%), and mixed (1.8 % each: SI + HD and HD + PR). The students built 146 distinct semantic axes, resulting in an average of 4.8/ participant. During the analysis, 438 interpretation processes were executed (average of 14.6/participant), and 124 combination processes (average of 4.1/participant). Conclusions: The nonanalytic strategies prevailed with the PR being the most used in the development of primary hypotheses (46.8%) and the SI in secondary hypotheses (93%). The interns showed a strong semantic network and did three and a half times more interpretation than combination processes, reflecting less deep organization and content of knowledge when compared with experienced physicians.
dc.format.mediumtext/html
dc.languageen
dc.language.isoeng
dc.publisherAssociação Brasileira de Educação Médica
dc.relation.ispartof10.1590/1981-52712018v42n1rb20160104
dc.rightsinfo:eu-repo/semantics/openAccess
dc.sourceRevista Brasileira de Educação Médica v.42 n.1 2018
dc.subjectDiagnosis
dc.subjectThought
dc.subjectStudents
dc.subjectProblem Solving
dc.titleThe Process of Clinical Reasoning among Medical Students
dc.typeinfo:eu-repo/semantics/article
ge.collectioncode0100-5502
ge.dataimportlabelOAI metadata object
ge.identifier.legacyglobethics:16042342
ge.identifier.permalinkhttps://www.globethics.net/gel/16042342
ge.lastmodificationdate2018-12-29 00:35
ge.lastmodificationuseradmin@pointsoftware.ch (import)
ge.submissions0
ge.oai.exportid149512
ge.oai.repositoryid1796
ge.oai.setnameRevista Brasileira de Educação Médica
ge.oai.setspec0100-5502
ge.oai.streamid2
ge.setnameGlobeEthicsLib
ge.setspecglobeethicslib
ge.linkhttp://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-55022018000100115


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