Clinical problem solving: a behavioral analysis. 1978

J P Kassirer, and G A Gorry

To extend the understanding of the clinical problem-solving process, we have analyzed the tape-recorded behavior of experienced clinicians engaged in "taking the history of the present illness" from a simultated patient. We showed that specific diagnostic hypotheses were generated often with little more information than presenting complaints, that testing of diagnostic hypotheses consisted of various case-building strategies for corroborating and discrediting hypotheses, and that the process of information gathering included techniques to evaluate the validity of data and assess the need for immediate action. Overall strategies were more difficult to discern but included a focused approach, a systemic exploration method, and a chronologic technique. The data have potential value in medical education and in developing computer programs to simulate the diagnostic process.

UI MeSH Term Description Entries
D008487 Medical History Taking Acquiring information from a patient on past medical conditions and treatments. Medical History, Previous,Past Medical History, Family,Previous Medical History,Family Health History,Family History, Health,Family History, Medical,Family Medical History,History Taking, Medical,Family Health Histories,Family Medical Histories,Health Family Histories,Health Family History,Health History, Family,History, Previous Medical,Medical Family Histories,Medical Family History,Medical Histories, Previous,Medical History, Family,Previous Medical Histories
D008722 Methods A series of steps taken in order to conduct research. Techniques,Methodological Studies,Methodological Study,Procedures,Studies, Methodological,Study, Methodological,Method,Procedure,Technique
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011340 Problem Solving A learning situation involving more than one alternative from which a selection is made in order to attain a specific goal.
D003933 Diagnosis The determination of the nature of a disease or condition, or the distinguishing of one disease or condition from another. Assessment may be made through physical examination, laboratory tests, or the likes. Computerized programs may be used to enhance the decision-making process. Diagnose,Diagnoses and Examination,Antemortem Diagnosis,Diagnoses and Examinations,Examinations and Diagnoses,Postmortem Diagnosis,Antemortem Diagnoses,Diagnoses,Diagnoses, Antemortem,Diagnoses, Postmortem,Diagnosis, Antemortem,Diagnosis, Postmortem,Examination and Diagnoses,Postmortem Diagnoses
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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