This study evaluates the hypothesis that medical reasoning in real clinical situations involves multiple cognitive tasks whose complex interactions are coordinated in an opportunistic manner. A problem-solving architecture originating from research in artificial intelligence, the blackboard model, is proposed as an integrative framework for representing these characteristics of situated medical reasoning and for reconciling different theoretical perspectives about medical reasoning. A naturalistic clinical situation, involving the manipulation of the patient record by an internist while managing a case, provides the empirical data for this in depth qualitative case study. The video recording of the subject's record manipulation behavior allows the cueing of retrospective think-aloud verbalizations and the preservation of the real-time aspects of problem solving. The association of theory-driven task analysis using the blackboard model with data-driven propositional analysis confirm that medical reasoning in this situation indeed comprises a variety of cognitive tasks, which are described. Also, the opportunistic character of control knowledge and the complex interactions between control strategies and cognitive tasks are confirmed and described. The blackboard model allows the principled representation of these characteristics of situated medical reasoning, thus supporting its integrative character. However, certain aspects of the data, mostly related to the ambivalence of several concepts that are used by the subject during the course of problem-solving, are not explained in the most parsimonious manner by the blackboard model, nor by symbolic cognitive architectures in general. A connectionist alternative is proposed which seems to better account for these phenomena. Finally, a tentative neurophysiological interpretation of the blackboard framework is offered for integrating the symbolic and connectionist perspectives. This study has additional implications con
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.40115 |
| Date | January 1996 |
| Creators | Farand, Lambert |
| Contributors | Patel, Vimla L. (advisor) |
| 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 | Doctor of Philosophy (Department of Educational and Counselling Psychology.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001500485, proquestno: NN12365, Theses scanned by UMI/ProQuest. |
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