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Patient Management Problems is a paper and pencil self-assessment procedure administered by the American College of Surgeons. The participant is presented with a number of problems, each of which describes a patient with an illness or injury. For each problem, the participant must assume the role of surgeon on duty and make decisions as to what he would do next in order to formulate a diagnosis. Each decision is scored in a prescribed manner. Upon completion of the problem, the participant's score reflects his knowledge and clinical competence. Dr. C. B. Mueller (Health Sciences, McMaster University) has defined a requirement to investigate the feasibility of evaluating a surgeon's ability to discriminate between critical and noncritical information available from a patient. This investigation will employ an evaluation process similar to the one used in Patient Management Problems but will be computerized and will be scored in terms of completeness and efficiency. This computerized evaluation tool will be referred to as McMaster Patient Management Problems (MPMP). This project paper will describe the activities surrounding the development of McMaster Patient Management Problems. / Thesis / Master of Science (MS)

Insight problems are often comprised of a period of impasse during which no new attempts are generated followed by an abrupt realization of the solution arising from the restructuring of an initial flawed problem representation. However, the precise mechanisms precipitating these processes are still being investigated. One hypothesis is that analyzing the unchanging elements of previous attempts may facilitate restructuring. We investigated this hypothesis using three classic insight problems. Participants were provided either three common examples of unsuccessful problem attempts, their own problem attempts, or no previous attempts. The prior attempts conditions eliminate the need to rely on memory to access previous unsuccessful attempts so that this mechanism could be investigated. Individual differences in working memory capacity and cognitive reflection were also collected. While there was no overall effect of the prior attempts conditions, both working memory and cognitive reflection were identified as significant predictors of restructuring and solving across problems and conditions.

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