Knowledge and clinical problem‐solving
Abstract
Summary. A consistent finding in the literature on measures of clinical problem‐solving scores is that there are very low correlations across different problems. This phenomenon is commonly labelled ‘content‐specificity’, implying that the scores differ because the content knowledge necessary to solve the problems differs. The present study tests this hypothesis by presenting groups of residents and clinical clerks with a series of simulated patient problems in which content was systematically varied. Each subject also completed a multiple choice test with questions linked to each diagnosis presented in the clinical problems. Three of the four problem‐solving scores showed low correlations, even to two presentations of the same problem, and no relationship to content differences. None of the scores were related to performance on the multiple choice test. The results suggest that variability in problem‐solving scores is related to factors other than content knowledge, and several possibilities are discussed.
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Expert knowledge is very specific to the domain in which the expert practices (context- or content-specific).
“Firstly, the nature of expert knowledge is such that it is very specific to the domain in which the expert practices, that is, it is context-or content-specific (Norman et al 1985, Benner & Tanner 1987, Edwards 1998)”
From The acquisition and exercise of nephrology nursing expertise: a grounded theory study (2006) · cites this paper as Norman et al 1985
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Programmatic assessment: From assessment of learning to assessment for learning
Schuwirth, L. W. T., & Van der Vleuten, C. P. M. (2011) · Medical Teacher · doi:10.3109/0142159x.2011.565828 · Cited by 902 · see citing works
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- Authors
- NORMAN, G. R., TUGWELL, P., FEIGHTNER, J. W., MUZZIN, L. J., & JACOBY, L. L.
- Affiliations
- McMaster University (CA)
- Corresponding author
- NORMAN, G. R.
- Venue
- Medical Education
- Publisher
- Wiley
- Published
- 1985-09
- Volume
- 19
- Issue
- 5
- Pages
- 344-356
- ISSN
- 0308-0110 (ISSN-L)
- 1365-2923
- OpenAlex
- W2044473672
- Cited by
- 180
- References
- 4
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 10 · 2022: 4 · 2021: 3 · 2020: 8 · 2019: 3 · 2018: 6 · 2017: 1 · 2016: 6 · 2015: 2 · 2014: 6 · 2013: 2 · 2012: 6
- FWCI
- 5.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Education (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Health Professions › Speech and Hearing › Problem Solving Skills Development
- Keywords
- clinical problem solving, content specificity, content knowledge, medical residents, multiple-choice tests, inter-rater reliability, clinical reasoning
- MeSH terms
- Canada, Clinical Clerkship, Diagnosis, Education, Medical, Undergraduate, Humans, Internship and Residency, Medicine, Problem Solving, Specialization
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