Thesis (M.S.)--Brigham Young University. Dept. of Computer Science, 2005. / Includes bibliographical references (p. 49-50).

Thesis (MAppSc in Physiotherapy) -- University of South Australia, 1993

Thesis (doctoral)--Tampereen yliopisto, 1985. / Extra t.p. with thesis statement inserted. Summary in English. Includes bibliographical references (p. 161-169).

Thesis (Ph. D.)--Drexel University, 2005. / Includes abstract and vita. Includes bibliographical references (leaves 121-124).

It is important for doctors to be clinically competent and this clinical competence is influenced by their clinical reasoning ability. Most research in this area has focussed on clinical reasoning ability measured in a problem - solving context. For this study, clinical reasoning is described as the process of working through a clinical problem which is distinct from a clinical problem solving approach that focuses more on the outcome of a correct diagnosis. Although the research literature into clinical problem solving and clinical reasoning is extensive, little is known about how undergraduate medical students develop their clinical reasoning ability. Evidence to support the validity of existing measures of undergraduate medical student clinical reasoning is limited. In order better to train medical students to become competent doctors, further investigation into the development of clinical reasoning and its measurement is necessary. Therefore, this study explored the development of medical students' clinical reasoning ability as they progressed through the first two years of a student - directed undergraduate problem - based learning ( PBL ) program. The relationships between clinical reasoning, knowledge base, critical thinking ability and learning approach were also explored. Instruments to measure clinical reasoning and critical thinking ability were developed, validated and used to collect data. This study used both qualitative and quantitative approaches to investigate the development of students' clinical reasoning ability over the first two years of the undergraduate medical program, and the factors that may impact upon this process. 113 students participated in this two - year study and a subset sample ( N = 5 ) was investigated intensively as part of the longtitudinal qualitative research. The clinical reasoning instrument had good internal consistency ( Cronbach alpha coefficient 0.94 for N = 145 ), inter - rater reliability ( r = 0.84, p < 0.05 ), and intrarater reliability ( r = 0.81, p < 0.01 ) when used with undergraduate medical students. When the instrument designed to measure critical thinking ability was tested with two consecutive first year medical student cohorts ( N = 129, N = 104 ) and one first year science student cohort ( N = 92 ), the Cronbach Alpha coefficient was 0.23, 0.45 and 0.67 respectively. Students ' scores for clinical reasoning ability on the instrument designed as part of this research were consistent with the qualitative data reported in the case studies. The relationships between clinical reasoning, critical thinking ability, and approach to learning as measured through the instruments were unable to be defined. However, knowledge level and the ability to apply this knowledge did correlate with clinical reasoning ability. Five student - related factors extrapolated from the case study data that influenced the development of clinical reasoning were ( 1 ) reflecting upon the modeling of clinical reasoning, ( 2 ) practising clinical reasoning, ( 3 ) critical thinking about clinical reasoning, ( 4 ) acquiring knowledge for clinical reasoning and ( 5 ) the approach to learning for clinical reasoning. This study explored students' clinical reasoning development over only the first two years of medical school. Using the clinical reasoning instrument with students in later years of the medical program could validate this instrument further. The tool used to measure students' critical thinking ability had some psychometric weaknesses and more work is needed to develop and validate a critical thinking instrument for the medical program context. This study has identified factors contributing to clinical reasoning ability development, but further investigation is necessary to explore how and to what extent factors identified in this study and other qualities impact on the development of reasoning, and the implications this has for medical training. / Thesis (Ph.D.)-- Medicine Learning and Teaching Unit, 2006.

Thesis (Ph. D.)--Stanford University, 1986. / Cover title. "June 1986." Includes bibliographical references.

Thesis (Ph. D.)--University of Sydney, 2007. / Title from title screen (viewed 17 Apr. 2007). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Physiotherapy, Faculty of Health Sciences. Includes bibliographical references. Also available in print form.

Thesis (Ph. D.)--University of Sydney, 2006. / Title from title screen (viewed 16 May 2007). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Physiotherapy, Faculty of Health Sciences. Includes bibliographical references. Also available in print form.

Clinical trials are important to the advancement of medical science. They provide the experimental and statistical basis needed to determine the benefit of diagnostic and therapeutic agents and procedures. The more patients enrolled in a clinical trial, the more confidence we can have in the trial's results. However, current practices for identifying eligible patients can be expensive and time-consuming. To assist in making identification of eligible patients more cost effective, we have developed a system for translating the eligibility criteria for clinical trials to an executable form. This system takes as input the eligibility criteria for a trial formatted as first order predicates. We then map these criteria against concepts in a target database. The mapped criteria are output as an Arden Syntax medical logic module using virtual medical record queries in the curly braces. The system was able to successfully process 85 out of 100 trials attempted. From these 85 trials, the system idendified 1,545 eligibility criteria. From these criteria, we generate 520 virtual medical record queries, 253 of which were deemed useful in helping to determine eligibility.

What strategies are effective for clinical nurse instructors to use in developing critical thinking in student nurses? Many clinical strategies have been discussed in, literature, but only a few have been verified through research as to their usefulness.This study used the qualitative research methodology of multiple case studies. Participants were six clinical nurse instructors. Nursing experience ranged from 17-27 years, teaching experience involved 2-24 years. Four instructors had doctorates, one nurse had a masters degree, and the sixth nurse lacked two courses before completing a masters degree. The six instructors were from five areas of nursing: medical/surgical (beginning and intermediate level), maternity, mental health, community health and management.Each instructor was interviewed three times during the same semester, approximately two weeks apart. Interviews were audio recorded and transcribed. Spradley's (1979) domain and taxonomic analyses were used to analyze the data.Data analysis showed that some strategies were used by all instructors, with adaptations made for the specialty. The strategies used by all instructors were questioning, nursing care plans and clinical conferences. More than one instructor used student journals, teaching projects, research articles, milieu assessments, and case studies/scenarios.This research strongly supported the use of questioning to help the student progress in critical thinking. Contrary to some research, the present research found that questioning by the instructors was not detached but was situated in the client setting which helped the student synthesize facts into a whole. The research identified many questions used by the clinical nurse instructors.Instructors identified their role in assisting students toward critical thinking as helper, facilitator, coach and guide. Instructors also identified the following characteristics as necessary to help students: caring attitude, creativity, perseverance, knowledgeable, listener, encourager and learning attitude. The instructors motivated students as they progressed in critical thinking through verbal and nonverbal rewards. Students gained self-confidence as they experienced success in their journey towards critical thinking. Implications for nursing practice are provided. The importance of this research lies in the rich depth of discovering how these strategies, roles, characteristics, and motivators assist nursing students in developing critical thinking skills in different clinical settings.2 / Department of Educational Leadership