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Illness script theory

Eileen F Hennrikus, Michael P Skolka, Nicholas Hennrikus
Problem: Medical school curriculum continues to search for methods to develop a conceptual educational framework that promotes the storage, retrieval, transfer, and application of basic science to the human experience. To achieve this goal, we propose a metacognitive approach that integrates basic science with the humanistic and health system aspects of medical education. Intervention: During the week, via problem-based learning and lectures, first-year medical students were taught the basic science underlying a disease...
January 2018: Journal of Medical Education and Curricular Development
Sandeep Gangadharan, Gunjan Tiyyagura, Marcie Gawel, Barbara M Walsh, Linda L Brown, Megan Lavoie, Khoon-Yen Tay, Marc A Auerbach
OBJECTIVE: The objective of this study was to explore pediatric emergency department (PED) and general emergency department (GED) providers' perceptions on caring for critically ill infants and children. METHODS: This study utilized qualitative methods to examine the perceptions of emergency department providers caring for critically ill infants and children. Teams of providers participated in 4 in situ simulation cases followed by facilitated debriefings. Debriefings were recorded and professionally transcribed...
August 2018: Pediatric Emergency Care
John L Musgrove, Jason Morris, Carlos A Estrada, Ryan R Kraemer
Background Published clinical problem solving exercises have emerged as a common tool to illustrate aspects of the clinical reasoning process. The specific clinical reasoning terms mentioned in such exercises is unknown. Objective We identified which clinical reasoning terms are mentioned in published clinical problem solving exercises and compared them to clinical reasoning terms given high priority by clinician educators. Methods A convenience sample of clinician educators prioritized a list of clinical reasoning terms (whether to include, weight percentage of top 20 terms)...
May 2016: Journal of Graduate Medical Education
Jake Hayward, Amandy Cheung, Alkarim Velji, Jenny Altarejos, Peter Gill, Andrew Scarfe, Melanie Lewis
Context/Setting: The script theory of diagnostic reasoning proposes that clinicians evaluate cases in the context of an "illness script," iteratively testing internal hypotheses against new information eventually reaching a diagnosis. We present a novel tool for teaching diagnostic reasoning to undergraduate medical students based on an adaptation of script theory. INTERVENTION: We developed a virtual patient case that used clinically authentic audio and video, interactive three-dimensional (3D) body images, and a simulated electronic medical record...
November 2016: Medical Teacher
Stuart Lubarsky, Valérie Dory, Marie-Claude Audétat, Eugène Custers, Bernard Charlin
Script theory proposes an explanation for how information is stored in and retrieved from the human mind to influence individuals' interpretation of events in the world. Applied to medicine, script theory focuses on knowledge organization as the foundation of clinical reasoning during patient encounters. According to script theory, medical knowledge is bundled into networks called 'illness scripts' that allow physicians to integrate new incoming information with existing knowledge, recognize patterns and irregularities in symptom complexes, identify similarities and differences between disease states, and make predictions about how diseases are likely to unfold...
2015: Canadian Medical Education Journal
Marcus D Bloice, Klaus-Martin Simonic, Andreas Holzinger
BACKGROUND: Virtual Patients are a well-known and widely used form of interactive software used to simulate aspects of patient care that students are increasingly less likely to encounter during their studies. However, to take full advantage of the benefits of using Virtual Patients, students should have access to multitudes of cases. In order to promote the creation of collections of cases, a tablet application was developed which makes use of electronic health records as material for Virtual Patient cases...
August 7, 2014: BMC Medical Informatics and Decision Making
Ryan M Richard, Ka Un Lao, John M Herbert
Conspectus The past 15 years have witnessed an explosion of activity in the field of fragment-based quantum chemistry, whereby ab initio electronic structure calculations are performed on very large systems by decomposing them into a large number of relatively small subsystem calculations and then reassembling the subsystem data in order to approximate supersystem properties. Most of these methods are based, at some level, on the so-called many-body (or "n-body") expansion, which ultimately requires calculations on monomers, dimers, ...
September 16, 2014: Accounts of Chemical Research
Nathan Kow, Mark D Walters, Mickey M Karram, Carlos J Sarsotti, J Eric Jelovsek
OBJECTIVE: To measure surgical judgment across the Obstetrics and Gynecology (OBGYN) continuum of practice and identify factors that correlate with improved surgical judgment. METHODS: A 45-item written examination was developed using script concordance theory, which compares an examinee's responses to a series of "ill-defined" surgical scenarios to a reference panel of experts. The examination was administered to OBGYN residents, Female Pelvic Medicine and Reconstructive Surgery (FPMRS) fellows, practicing OBGYN physicians and FPMRS experts...
August 2014: Medical Teacher
E Martín Padilla, P Sarmiento Medina, A Ramírez Jaramillo
OBJECTIVE: To Identify aspects of professional communication that affect the quality of long-term care for patients with chronic illness or disabilities and their families, in the experience of health professionals, as input for the development of an assessment tool. MATERIAL AND METHOD: Descriptive qualitative.The data was processed by performing an interpretative analysis from grounded theory. The participants included 12 health professionals (three doctors, three nurses, three therapists and three psychologists), who work at the Hospital of the Universidad de La Sabana, Chia, and other institutions in Bogota, Colombia,with more than five years experience in programs treating chronic disease or disability in hospital therapeutic contexts...
May 2014: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
Alireza Monajemi, Kamran Soltani Arabshahi, Akbar Soltani, Farshid Arbabi, Roghieh Akbari, Eugene Custers, Arash Hadadgar, Fatemeh Hadizadeh, Tahereh Changiz, Peyman Adibi
BACKGROUND: Although some tests for clinical reasoning assessment are now available, the theories of medical expertise have not played a major role in this filed. In this paper, illness script theory was chose as a theoretical framework and contemporary clinical reasoning tests were put together based on this theoretical model. MATERIALS AND METHODS: This paper is a qualitative study performed with an action research approach. This style of research is performed in a context where authorities focus on promoting their organizations' performance and is carried out in the form of teamwork called participatory research...
2012: Journal of Education and Health Promotion
Stuart Lubarsky, Valérie Dory, Paul Duggan, Robert Gagnon, Bernard Charlin
The script concordance test (SCT) is used in health professions education to assess a specific facet of clinical reasoning competence: the ability to interpret medical information under conditions of uncertainty. Grounded in established theoretical models of knowledge organization and clinical reasoning, the SCT has three key design features: (1) respondents are faced with ill-defined clinical situations and must choose between several realistic options; (2) the response format reflects the way information is processed in challenging problem-solving situations; and (3) scoring takes into account the variability of responses of experts to clinical situations...
2013: Medical Teacher
Alireza Monajemi, Henk G Schmidt, Remy M J P Rikers
INTRODUCTION: Illness script theory offers explanations for expert-novice differences in clinical reasoning. However, it has mainly focused on diagnostic (Dx) performance, while patient management (Mx) has been largely ignored. The aim of the present study was to show the role of Mx knowledge in illness script development and how it relates to diagnostic knowledge in the course of development toward expertise. METHODS: The participants were 10 fourth-year and 10 sixth-year medical students, and 10 experienced physicians (ie, internists)...
2012: Journal of Continuing Education in the Health Professions
Lambert W T Schuwirth, Cees P M van der Vleuten
There are no scientific theories that are uniquely related to assessment in medical education. There are many theories in adjacent fields, however, that can be informative for assessment in medical education, and in the recent decades they have proven their value. In this AMEE Guide we discuss theories on expertise development and psychometric theories, and the relatively young and emerging framework of assessment for learning. Expertise theories highlight the multistage processes involved. The transition from novice to expert is characterised by an increase in the aggregation of concepts from isolated facts, through semantic networks to illness scripts and instance scripts...
2011: Medical Teacher
Sara R Alcorn, Michael J Balboni, Holly G Prigerson, Amy Reynolds, Andrea C Phelps, Alexi A Wright, Susan D Block, John R Peteet, Lisa A Kachnic, Tracy A Balboni
BACKGROUND: This study sought to inductively derive core themes of religion and/or spirituality (R/S) active in patients' experiences of advanced cancer to inform the development of spiritual care interventions in the terminally ill cancer setting. METHODS: This is a multisite, cross-sectional, mixed-methods study of randomly-selected patients with advanced cancer (n = 68). Scripted interviews assessed the role of R/S and R/S concerns encountered in the advanced cancer experience...
May 2010: Journal of Palliative Medicine
Miriam van Mersbergen, Christopher Patrick, Leslie Glaze
PURPOSE: Previous research has proposed that persons with functional dysphonia (FD) present with temperamental traits that predispose them to their voice disorder. We investigated this theory in a controlled experiment and compared them with social anxiety (SA) and healthy control (HC) groups. METHOD: Twelve participants with FD, 19 participants with SA, and 23 HC participants were studied before, during, and after mental imagery of positive, neutral, and aversive scripts in a within-subject reversal paradigm with multiple experimental conditions using psychometric, self-report, and psychophysiological measures...
December 2008: Journal of Speech, Language, and Hearing Research: JSLHR
Bernard Charlin, Henny P A Boshuizen, Eugene J Custers, Paul J Feltovich
CONTEXT: Each clinical encounter represents an amazing series of psychological events: perceiving the features of the situation; quickly accessing relevant hypotheses; checking for signs and symptoms that confirm or rule out competing hypotheses, and using related knowledge to guide appropriate investigations and treatment. OBJECTIVE: Script theory, issued from cognitive psychology, provides explanations of how these events are mentally processed. This essay is aimed at clinical teachers who are interested in basic sciences of education...
December 2007: Medical Education
Melanie A Porter, Max Coltheart, Robyn Langdon
This study examined Theory of Mind in Williams syndrome (WS) and in normal chronological age-matched and mental age-matched control groups, using a picture sequencing task. This task assesses understanding of pretence, intention and false belief, while controlling for social-script knowledge and physical cause-and-effect reasoning. The task was selected because it is entirely non-verbal, so that the WS individuals could not rely on their good verbal skills when performing the task. Results indicated a specific deficit in understanding of false belief within the WS group...
May 2008: Journal of Autism and Developmental Disorders
Sarkis Meterissian, Brent Zabolotny, Robert Gagnon, Bernard Charlin
BACKGROUND: Intraoperative decision making requires both knowledge and experience. The script concordance test (SCT), based on cognitive psychology script theory, is a new tool of clinical-reasoning assessment that may be used to evaluate a candidate's approach to ill-defined problems encountered in the operating room. METHODS: To develop and validate an SCT for assessment of intraoperative decision making. One hundred questions were prepared based on the objectives for residency training of the American Board of Surgery...
February 2007: American Journal of Surgery
Eugene Carragee, Todd Alamin, Ivan Cheng, Thomas Franklin, Eric Hurwitz
STUDY DESIGN: Prospective, 5-year, cohort study of working subjects. OBJECTIVES: To assess whether the occurrence of common minor trauma events affects the risk of developing serious low back pain (LBP) and LBP disability in subjects with and without degenerative changes to the lumbar spine. SUMMARY OF BACKGROUND DATA: Although some theories suggest that minor traumatic events in combination with preexisting degenerative changes commonly cause significant structural injury to spinal segments and serious LBP illness, no prospective data exist on the relationship of minor trauma, detailed structural changes, and outcome measures of serious LBP episodes and occupational disability...
December 1, 2006: Spine
Robert Gagnon, Bernard Charlin, Louise Roy, Monique St-Martin, Evelyne Sauvé, Henny P A Boshuizen, Cees van der Vleuten
BACKGROUND: According to the theory on which the Script Concordance Test (SCT) is based, scripts contain expectations on features that are associated with each illness and about the range of values that are typical, atypical, or incompatible. PURPOSE: To document the construct validity of the SCT, we investigated the theory prediction that once a script is activated, new incoming information (e.g., additional clinical features) is processed faster if it is typical for that script than if it is atypical...
2006: Teaching and Learning in Medicine
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