Medical decisions in perspective: applied research in cognitive psychology.
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Biomedical subjects
Publications and source records attributed to A S Elstein.
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An existing multidisciplinary sequence in the preclinical curriculum of the College of Human Medicine at Michigan State University has been revised to include emphasis on psychological principles of clinical reasoning, decision analysis, ethical issues, and health economics. The course is a four-term sequence taught in the first and second years. In each term, the course consists of a one-hour lecture and two hours of group discussion weekly. The focus of the discussions is a series of carefully constructed paper-and-pencil cases that are graded in difficulty and coordinated with concurrent or previous biological science courses. Examinations have been developed based on written cases and using multiple choice, true-false, and short essay questions. The course is aimed at bringing about fundamental change in the new physicians' conceptions of value and benefit, the way uncertainty is managed, and the traditional belief that data and information are identical.
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A medical cognitive preference inventory was developed and tested with two samples, one in Israel and the other in the United States. Acceptable levels of internal consistency of the whole test and of its three subtests were demonstrated. Direct and indirect evidence for the validity of the test was provided. The potential uses of the test for student selection and evaluation as well as for programme evaluation were discussed. Two forms, E and F, each consisting of eighteen items, are recommended for use with medical students. A combination of these two forms is designed as form G. Administration of one form to half of a sample and the other form to the other half, followed by pooling the individual scores, thereby obtaining results comparable to those of form G, is recommended when time to administer the inventory is limited.
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