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Intuition in medical practice

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https://www.readbyqxmd.com/read/28344696/systems-1-and-2-thinking-processes-and-cognitive-reflection-testing-in-medical-students
#1
Shu Wen Tay, Paul Ryan, C Anthony Ryan
BACKGROUND: Diagnostic decision-making is made through a combination of Systems 1 (intuition or pattern-recognition) and Systems 2 (analytic) thinking. The purpose of this study was to use the Cognitive Reflection Test (CRT) to evaluate and compare the level of Systems 1 and 2 thinking among medical students in pre-clinical and clinical programs. METHODS: The CRT is a three-question test designed to measure the ability of respondents to activate metacognitive processes and switch to System 2 (analytic) thinking where System 1 (intuitive) thinking would lead them astray...
October 2016: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/28341982/pocket-sized-point-of-care-cardiac-ultrasound-devices-role-in-the-emergency-department
#2
A Colclough, P Nihoyannopoulos
BACKGROUND: Acute breathlessness accounts for 8% of accident and emergency attendances. Point-of-care cardiac ultrasound (US) effectively reduces time to diagnosis. Fast and practical information via pocket-sized cardiac US devices may better the diagnosis in this complex patient group. METHODS: We prospectively enrolled 40 consecutive patients presenting with shortness of breath at the emergency department (ED). Divided into two groups were all adult patients over 18 with acute breathing difficulties (triage category 1-3): 21 patients received a short focused cardiac US scan using a pocket-sized Vscan and 19 patients received no scan...
March 24, 2017: Herz
https://www.readbyqxmd.com/read/28296165/nice-to-watch-students-evaluate-online-lectures
#3
Nancy Sturman, Benjamin Mitchell, Amy Mitchell
BACKGROUND: Many clinical teachers who previously gave face-to-face lectures now record presentations for students to view asynchronously online. These teachers need to understand student expectations of online lectures (OLLs), and their place in the overall 'ecology' of student learning resources, in order to ensure that students watch, and learn from, their lectures. METHODS: We conducted focus groups with a convenience sample of medical students undertaking their general practice placements, exploring student uses, evaluations and expectations of OLLs...
March 14, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28157389/critical-thinking-in-critical-care-five-strategies-to-improve-teaching-and-learning-in-the-intensive-care-unit
#4
Margaret M Hayes, Souvik Chatterjee, Richard M Schwartzstein
Critical thinking, the capacity to be deliberate about thinking, is increasingly the focus of undergraduate medical education, but is not commonly addressed in graduate medical education. Without critical thinking, physicians, and particularly residents, are prone to cognitive errors, which can lead to diagnostic errors, especially in a high-stakes environment such as the intensive care unit. Although challenging, critical thinking skills can be taught. At this time, there is a paucity of data to support an educational gold standard for teaching critical thinking, but we believe that five strategies, routed in cognitive theory and our personal teaching experiences, provide an effective framework to teach critical thinking in the intensive care unit...
April 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28129956/-medically-unexplained-symptoms-care-in-internal-medicine-a-paradigm-of-doctor-patient-relationship-in-situation-of-uncertainty
#5
B Ranque, O Nardon
Medically unexplained symptoms (MUS) are extremely common in general practice as in all medical specialties, but their designation is not unambiguous and the approaches to take care of the patients differ from conventional therapeutic approaches. The difficulty is not to confirm the diagnosis, which is rapidly obvious with some experience, but to establish a genuinely human therapeutic relationship, without any technical help, which pushes the doctor to the edge of his empathy and communication skills. The discomfort or even distress regularly encountered by physicians in front of a patient with MUS shows that the foundations of the doctor-patient relationship under uncertainty are poorly mastered...
January 24, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28122614/clinical-decision-making-in-the-recognition-of-dying-a-qualitative-interview-study
#6
Paul Taylor, Dawn Dowding, Miriam Johnson
BACKGROUND: Recognising dying is an essential clinical skill for general and palliative care professionals alike. Despite the high importance, both identification and good clinical care of the dying patient remains extremely difficult and often controversial in clinical practice. This study aimed to answer the question: "What factors influence medical and nursing staff when recognising dying in end-stage cancer and heart failure patients?" METHODS: This study used a descriptive approach to decision-making theory...
January 25, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28048739/tu-ab-207a-03-image-quality-dose-and-clinical-applications
#7
F Dong
Practicing medical physicists are often time charged with the tasks of evaluating and troubleshooting complex image quality issues related to CT scanners. This course will equip them with a solid and practical understanding of common CT imaging chain and its major components with emphasis on acquisition physics and hardware, reconstruction, artifacts, image quality, dose, and advanced clinical applications. The core objective is to explain the effects of these major system components on the image quality. This course will not focus on the rapid-changing advanced technologies given the two-hour time limit, but the fundamental principles discussed in this course may facilitate better understanding of those more complicated technologies...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048020/tu-ab-207a-00-ct-systems-course
#8
Baojun Li
Practicing medical physicists are often time charged with the tasks of evaluating and troubleshooting complex image quality issues related to CT scanners. This course will equip them with a solid and practical understanding of common CT imaging chain and its major components with emphasis on acquisition physics and hardware, reconstruction, artifacts, image quality, dose, and advanced clinical applications. The core objective is to explain the effects of these major system components on the image quality. This course will not focus on the rapid-changing advanced technologies given the two-hour time limit, but the fundamental principles discussed in this course may facilitate better understanding of those more complicated technologies...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047355/tu-ab-207a-01-image-acquisition-physics-and-hardware
#9
B Li
Practicing medical physicists are often time charged with the tasks of evaluating and troubleshooting complex image quality issues related to CT scanners. This course will equip them with a solid and practical understanding of common CT imaging chain and its major components with emphasis on acquisition physics and hardware, reconstruction, artifacts, image quality, dose, and advanced clinical applications. The core objective is to explain the effects of these major system components on the image quality. This course will not focus on the rapid-changing advanced technologies given the two-hour time limit, but the fundamental principles discussed in this course may facilitate better understanding of those more complicated technologies...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046685/tu-ab-207a-02-image-reconstruction-and-artifact-reduction
#10
J Hsieh
Practicing medical physicists are often time charged with the tasks of evaluating and troubleshooting complex image quality issues related to CT scanners. This course will equip them with a solid and practical understanding of common CT imaging chain and its major components with emphasis on acquisition physics and hardware, reconstruction, artifacts, image quality, dose, and advanced clinical applications. The core objective is to explain the effects of these major system components on the image quality. This course will not focus on the rapid-changing advanced technologies given the two-hour time limit, but the fundamental principles discussed in this course may facilitate better understanding of those more complicated technologies...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28031958/life-as-an-early-career-researcher-interview-with-kavita-beri
#11
Kavita Beri
Kavita Beri speaks to Francesca Lake, Managing Editor. Kavita Beri is a board certified Internal Medicine physician in the United States, and is an active member of the American Society of Laser Medicine and Surgery. She is the medical director and owner of BE Skin & Laser Med Spa, an aesthetic medicine practice in NJ, USA. She holds a position as a Visiting Scientist at the Department of Biomaterials and Center for Dermal Research at Rutgers University (NJ, USA) and is an active staff member in the Department of Medicine at Jersey Shore University Medical Center (NJ, USA)...
June 2016: Future Science OA
https://www.readbyqxmd.com/read/27981654/knowing-how-we-know-an-epistemological-rationale-for-the-medical-humanities
#12
Neville Chiavaroli
CONTEXT: Although their inclusion in medical curricula internationally is increasing, the medical humanities still face challenges to their role and place in the curriculum. Justifications supporting the inclusion of humanities content, methods and perspectives in medical curricula have generally been proposed along instrumental, intrinsic and critical lines. However, recent literature in the field has turned to 'ways of knowing' as representing an alternative, essentially epistemological, perspective on the matter...
January 2017: Medical Education
https://www.readbyqxmd.com/read/27905060/perioperative-risk-adjustment-for-total-shoulder-arthroplasty-are-simple-clinically-driven-models-sufficient
#13
David N Bernstein, Aakash Keswani, David Ring
BACKGROUND: There is growing interest in value-based health care in the United States. Statistical analysis of large databases can inform us of the factors associated with and the probability of adverse events and unplanned readmissions that diminish quality and add expense. For example, increased operating time and high blood urea nitrogen (BUN) are associated with adverse events, whereas patients on antihypertensive medications were more likely to have an unplanned readmission. Many surgeons rely on their knowledge and intuition when assessing the risk of a procedure...
November 30, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27884918/patients-beliefs-on-the-impediments-to-good-diabetes-control-a-mixed-methods-study-of-patients-in-general-practice
#14
Amanda Jane Elliott, Fiona Harris, Sandra G Laird
BACKGROUND: Most people with diabetes are not attaining desirable levels of HbA1c (glycated haemoglobin), or of blood pressure and cholesterol, leaving them at risk of developing complications. AIM: To identify ways of improving diabetes control by gaining insight into patients' attitudes/beliefs. DESIGN AND SETTING: Questionnaires were offered to patients attending for a diabetes review in the 24 GP practices of North East Hampshire and Farnham Clinical Commissioning Group...
December 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27876238/thermography-examination-of-abdominal-area-skin-temperatures-in-individuals-with-and-without-focal-onset-epilepsy
#15
Hollis H King, Charles Thomas Cayce, Jeph Herrin
Early osteopathic theory and practice, and the work of the medical intuitive Edgar Cayce suggested that the abdominal areas of individuals with epilepsy would manifest "cold spots." The etiology for this phenomenon was thought to be abdominal adhesions caused by inflammation and viscero-somatic reflexes caused by adhesions or injury to visceral or musculoskeletal system structures. Indeed, until that advent of electroencephalography in the 1930s, medical practice regarding epilepsy focused on abdominal neural and visceral structures...
January 2017: Explore: the Journal of Science and Healing
https://www.readbyqxmd.com/read/27856021/interdisciplinary-development-of-an-improved-emergency-department-procedural-work-surface-through-iterative-design-and-use-testing-in-simulated-and-clinical-environments
#16
Xiao C Zhang, Ana M Bermudez, Pranav M Reddy, Ravi R Sarpatwari, Darin B Chheng, Taylor J Mezoian, Victoria R Schwartz, Quinneil J Simmons, Gregory D Jay, Leo Kobayashi
STUDY OBJECTIVE: A stable and readily accessible work surface for bedside medical procedures represents a valuable tool for acute care providers. In emergency department (ED) settings, the design and implementation of traditional Mayo stands and related surface devices often limit their availability, portability, and usability, which can lead to suboptimal clinical practice conditions that may affect the safe and effective performance of medical procedures and delivery of patient care...
March 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27810113/prediction-of-occupational-disability-from-psychological-and-neuropsychological-evidence-in-forensic-context
#17
Izabela Z Schultz, Ada K Law, Leanna C Cruikshank
Within the fields of psychiatry, psychology, and neuropsychology, medical examiners are often tasked with providing an opinion about an injured individual's health prognosis and likelihood of returning to work. Traditionally, examiners have conducted such assessments by employing clinical intuition, expert knowledge, and judgment. More recently, however, an accumulation of research on factors predictive of disability has allowed examiners to provide prognostications using specific empirically supported evidence...
November 2016: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/27711938/the-effect-of-medical-education-on-attitudes-towards-schizophrenia-a-five-year-follow-up-study
#18
Ayşen Esen Danacı, Kuzeymen Balıkçı, Orkun Aydın, Cengiz Cengisiz, A Burak Uykur
OBJECTIVE: It has been widely acknowledged that the community and health professionals hold negative attitudes toward patients with impaired mental health. This constitutes a majör obstacle for those patients in coping with their disease, managing their care, and hence regulating their lives. Although studies carried out in Turkey document the presence of stigma, they provide limited information about the ways for solving this problem. Drawing on the litrature, the present study investigated the effect of medical education on stigmatization...
2016: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
https://www.readbyqxmd.com/read/27668841/rapid-response-teams-is-it-time-to-reframe-the-questions-of-rapid-response-team-measurement
#19
Gail G Salvatierra, Ruth C Bindler, Kenn B Daratha
PURPOSE: The purpose of this article is to present an overview of rapid response team (RRT) history in the United States, provide a review of prior RRT effectiveness research, and propose the reframing of four new questions of RRT measurement that are designed to better understand RRTs in the context of contemporary nursing practice as well as patient outcomes. ORGANIZING CONSTRUCT: RRTs were adopted in the United States because of their intuitive appeal, and despite a lack of evidence for their effectiveness...
September 26, 2016: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/27590603/a-qualitative-study-to-understand-guideline-discordant-use-of-imaging-to-stage-incident-prostate-cancer
#20
Danil V Makarov, Erica Sedlander, R Scott Braithwaite, Scott E Sherman, Steven Zeliadt, Cary P Gross, Caitlin Curnyn, Michele Shedlin
BACKGROUND: Approximately half of veterans with low-risk prostate cancer receive guideline-discordant imaging. Our objective was to identify and describe (1) physician knowledge, attitudes, and practices related to the use of imaging to stage prostate cancer, (2) patient attitudes and behaviors related to use of imaging, and (3) to compare responses across three VA medical centers (VAMCs). METHODS: A qualitative approach was used to explore patient and provider knowledge and behaviors relating to the use of imaging...
September 2, 2016: Implementation Science: IS
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