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"clinical reasoning"

Rabia S Atayee, Kashelle Lockman, Cara Brock, Daniel T Abazia, Tracy L Brooks, Jayne Pawasauskas, Kyle P Edmonds, Christopher M Herndon
INTRODUCTION: As the role of the pharmacist on the transdisciplinary palliative care team grows, the need for adequate instruction on palliative care and clinical reasoning skills in schools of pharmacy grows accordingly. METHODS: This study evaluates second- and third-year pharmacy students from 6 accredited schools of pharmacy that participated in surveys before and after the delivery of a didactic palliative care elective. The survey collected student demographics, perceptions of the importance of and student skill level in palliative care topics...
January 1, 2018: American Journal of Hospice & Palliative Care
Stephen W English, B Mark Keegan, Eoin P Flanagan, W Oliver Tobin, Nicholas L Zalewski
No abstract text is available yet for this article.
April 24, 2018: Neurology
Natalia Stathakarou, Andrzej A Kononowicz, Lars Henningsohn, Cormac McGrath
Virtual Patients (VPs) offer learners the opportunity to practice clinical reasoning skills and have recently been integrated in Massive Open Online Courses (MOOCs). Feedback is a central part of a branched VP, allowing the learner to reflect on the consequences of their decisions and actions. However, there is insufficient guidance on how to design feedback models within VPs and especially in the context of their application in MOOCs. In this paper, we share our experiences from building a feedback model for a bladder cancer VP in a Urology MOOC, following an iterative process in three steps...
2018: Studies in Health Technology and Informatics
David M Walton, James M Elliott
Common, enigmatic musculoskeletal conditions such as whiplash-associated disorder, myofascial pain syndrome, low back pain, headache, fibromyalgia, osteoarthritis, and rotator cuff pathology, account for significant social, economic, and personal burdens on a global scale. Despite their primacy (and shared sequelae) there remains a paucity of available and effective management options for patients with both acute and chronic conditions. Establishing an accurate prognostic or diagnostic profile on a patient-by-patient basis can challenge the insight of both novice and expert clinicians...
April 9, 2018: Musculoskeletal Science & Practice
Christine L Sommers
No abstract text is available yet for this article.
April 12, 2018: Nurse Education in Practice
Peter B O'Sullivan, J P Caneiro, Mary O'Keeffe, Anne Smith, Wim Dankaerts, Kjartan Fersum, Kieran O'Sullivan
Biomedical approaches for diagnosing and managing disabling low back pain (LBP) have failed to arrest the exponential increase in health care costs, with a concurrent increase in disability and chronicity. Health messages regarding the vulnerability of the spine and a failure to target the interplay among multiple factors that contribute to pain and disability may partly explain this situation. Although many approaches and subgrouping systems for disabling LBP have been proposed in an attempt to deal with this complexity, they have been criticized for being unidimensional and reductionist and for not improving outcomes...
May 1, 2018: Physical Therapy
Menachem M Sofer, Alexander Kaptsan, Jonathan Anson
OBJECTIVES: Currently, Israel has a single governmental inpatient dual diagnosis detoxification unit. We provide a cross-section of patient profiles in this unit, as well as explore possible associations between clinical/demographic factors, and the unplanned early discharge of patients from the unit, aiming at improving rehabilitation success rates. METHODS: In this retrospective study, medical records of all patients admitted to the unit between January 1st 2012 and July 1st 2013 were examined (N = 323)...
April 18, 2018: Journal of Dual Diagnosis
Jon Rosenberg, Whitley Aamodt, Samuel Takvorian, Michael Mullen
No abstract text is available yet for this article.
April 17, 2018: Neurology
Rishi Sharma, Tia Chakraborty, Francis K Buadi, Elena Beam, Vincent S Pureza, Gabriel L Pagani-Estevez, Eoin P Flanagan
No abstract text is available yet for this article.
April 17, 2018: Neurology
Kristy Nicola, Jemimah Waugh, Emily Charles, Trevor Russell
BACKGROUND: In rural and remote communities children with motor difficulties have less access to rehabilitation services. Telerehabilitation technology is a potential method to overcome barriers restricting access to healthcare in these areas. Assessment is necessary to guide clinical reasoning; however it is unclear which paediatric assessments can be administered remotely. The Movement Assessment Battery for Children - 2nd Edition is commonly used by various health professionals to assess motor performance of children...
April 12, 2018: Research in Developmental Disabilities
Reza Manesh, Gurpreet Dhaliwal
Physicians can improve their diagnostic acumen by adopting a simulation-based approach to analyzing published cases. The tight coupling of clinical problems and their solutions affords physicians the opportunity to efficiently upgrade their illness scripts (structured knowledge of a specific disease) and schemas (structured frameworks for common problems). The more times clinicians practice accessing and applying those knowledge structures through published cases, the greater the odds that they will have an enhanced approach to similar patient-cases in the future...
May 2018: Medical Clinics of North America
Bryan P Yan, William H S Lai, Christy K Y Chan, Stephen Chun-Hin Chan, Lok-Hei Chan, Ka-Ming Lam, Ho-Wang Lau, Chak-Ming Ng, Lok-Yin Tai, Kin-Wai Yip, Olivia T L To, Ben Freedman, Yukkee C Poh, Ming-Zher Poh
BACKGROUND: We aimed to evaluate a novel method of atrial fibrillation (AF) screening using an iPhone camera to detect and analyze photoplethysmographic signals from the face without physical contact by extracting subtle beat-to-beat variations of skin color that reflect the cardiac pulsatile signal. METHODS AND RESULTS: Patients admitted to the cardiology ward of the hospital for clinical reasons were recruited. Simultaneous facial and fingertip photoplethysmographic measurements were obtained from 217 hospital inpatients (mean age, 70...
April 5, 2018: Journal of the American Heart Association
P T Moueleu Ngalagou, E Ngouadjeu Dongho Tsakeu, F Ngo Sack, E C Eboumbou Moukoko, Y Konn Jolly, H Luma
Data about malignant blood diseases are sparse in Cameroon. Their epidemiology was studied in patients at the General Hospital of Douala (GHD) and the Yaoundé Central Hospital (CHY) from 2004 through 2014. The variables we studied were social and demographic (age, sex, occupation, marital status), clinical (reasons for consultation, clinical signs, year of diagnosis), and biological (blood count, myelogram and blood smear, immunophenotyping, biopsy, and cytogenetics). In all, 4409 files were reviewed and 454 cases identified, documented and confirmed (248 in GHD and 206 in CHY)...
February 1, 2018: Médecine et Santé Tropicales
Cynthia V Purcell
No abstract text is available yet for this article.
April 1, 2018: Journal of Nursing Education
Kristyn M Spera, Christopher T Doughty, Sashank Prasad
No abstract text is available yet for this article.
April 3, 2018: Neurology
Robert L Trowbridge, Andrew P J Olson
Diagnostic reasoning is one of the most challenging and rewarding aspects of clinical practice. As a result, facility in teaching diagnostic reasoning is a core necessity for all medical educators. Clinician educators' limited understanding of the diagnostic process and how expertise is developed may result in lost opportunities in nurturing the diagnostic abilities of themselves and their learners. In this perspective, the authors describe their journeys as clinician educators searching for a coherent means of teaching diagnostic reasoning...
March 28, 2018: Diagnosis
Mark L Graber, Monika Patel, Stephen Claypool
Diagnostic safety could theoretically be improved by high-level interventions, such as improving clinical reasoning or eliminating system-related defects in care, or by focusing more specifically on a single problem or disease. In this review, we consider how the timely diagnosis of sepsis has evolved and improved as an example of the disease-focused approach. This progress has involved clarifying and revising the definitions of sepsis, efforts to raise awareness, faster and more reliable laboratory tests and a host of practice-level improvements based on health services research findings and recommendations...
March 28, 2018: Diagnosis
Deborah DiNardo, Sarah Tilstra, Melissa McNeil, William Follansbee, Shanta Zimmer, Coreen Farris, Amber E Barnato
BACKGROUND: While there is some experimental evidence to support the use of cognitive forcing strategies to reduce diagnostic error in residents, the potential usability of such strategies in the clinical setting has not been explored. We sought to test the effect of a clinical reasoning tool on diagnostic accuracy and to obtain feedback on its usability and acceptability. METHODS: We conducted a randomized behavioral experiment testing the effect of this tool on diagnostic accuracy on written cases among post-graduate 3 (PGY-3) residents at a single internal medical residency program in 2014...
March 28, 2018: Diagnosis
Matan Fischer, Zahi Abu Ghosh, Limor Rubin, Fadi Kharouf, Oshrat Ayalon, Danna Dror, Batla Falah, Dror Mevorach
Sir William Osler is considered to be one of the fathers of modern medicine who pioneered the practice of bedside teaching of clinical medicine for medical students and residents. Osler was well known as a diagnostician and outstanding therapist with a humanized approach and rare didactic capabilities. Medical training at Hadassah is built on the central tenets of Osler's approach, incorporating the tremendous advances in science and medicine. Training for residents in Internal Medicine is designed to develop a broad base of medical and, if possible, scientific knowledge, as well as skills and competencies to deliver a high standard of patient care...
March 2018: Harefuah
L Karila, H François, X Monnet, N Noel, M Roupret, V Gajdos, O Lambotte, D Benhamou, A Benyamina
In recent years, there has been a major interest in assessing learners during their medical education. The core of medical competence is the clinical reasoning that should be acquired by all medical actors. Its assessment includes the ability to integrate and apply different types of knowledge, weigh critical evidence and think about the process used to have a diagnosis. French faculties of medicine will have to include it in the training and evaluation of students during 2017. It should therefore be part of the new docimological modalities of the computerized "Épreuves Classantes Nationales" from 2020 onwards...
March 22, 2018: La Revue de Médecine Interne
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