This study evaluated the ability of subjects at 3 levels of expertise, expert physicians, residents and medical students, in the acquisition, representation, and utilization of patient information in the context of solving a complex medical problem. Each subject interviewed a volunteer medical outpatient and was subsequently requested to provide a differential diagnosis. The doctor-patient dialogue was analyzed using cognitive methods of discourse analysis. These methods were used to characterize differences in the content and nature of the history-taking process and in the development of problem representations. The study characterized differences at two levels of representation, observations and findings. Observations are the minimal semantic units of the doctor patient discourse. Findings are higher order units that derive meaning in specific medical contexts. / Differences were found between groups of subjects in the accuracy of diagnoses and in the qualitative nature of representations. These differences were manifested most clearly in terms of a series of efficiency measures designed to characterize the ability of subjects to generate findings. In general, the expert physicians were more selective in the elicitation and processing of critical and relevant findings. An attempt is made to characterize these differences in terms of the strategies used to acquire and represent patient information.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.59603 |
| Date | January 1987 |
| Creators | Kaufman, David R. |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Arts (Department of Educational Psychology and Counselling.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 000945982, proquestno: AAIMM63765, Theses scanned by UMI/ProQuest. |
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