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By performing a series of five experiments with two subjects, several aspects of one of the subject's behavior in solving chess problems were found to be predictable, and a model was developed to explain this predictability. The heuristics used in this model may be applicable in developing future computer programs for chess play.
The objective of this paper is to provide an overview of the microbeam analytical techniques and to help select the appropriate one to solve complex problems often arising in today's high-tech industries. Case histories are given to show how renowned analytical service laboratories and microbeam experts formulated their strategies to approach a real life problem, what type of conclusions were deduced from the data and, finally, how the problem was solved.
This paper compares the hypothetico-deductive model of clinical problem solving commonly used in current nurse education and practice with the knowledge-driven problem-solving model (Bordage, Grant, & Marsden, 1990). It is argued that the knowledge-driven model provides a more complete account of the processes involved in clinical problem solving. The knowledge-driven model emphasizes the organization and availability of relevant content knowledge stored in memory as the prime determinant of clinical problem solving. This contention is discussed in relation to the development of a clinical problem-solving task for nursing students and its implications for nursing curricula.
In a widely cited study, Matas, Arend, and Sroufe showed that mother-toddler interaction during problem solving at age 2 years was related to the child's prior attachment security. The current study asked (1) whether an independent laboratory could replicate this attachment finding, and (2) whether problem-solving interactions relate to mother-child interactions observed at home and to child temperament measured at 6, 13, and 24 months. Replicating Matas et al., secure dyads worked more competently, and mothers showed better quality of assistance and supportive presence. Mother-child home interaction also predicted problem solving: positive involvement at home predicted effective, unconflicted problem solving. Negative control at home did not predict problem-solving interaction. Unadaptable temperament was generally related to dependency in problem solving. Several patterns of correlations appeared to be mediated by sex of child, e.g., difficult temperament in boys predicted more effective, unconflicted problem solving, while for girls it predicted more conflict.
The need to include in the medical curriculum instructional activities to promote the development of problem-solving abilities has been asserted at the national and international levels. In research on the mental process involved in the solution of problems in medicine, problem-solving has been defined as a hypothetical-deductive activity engaged in by experienced physicians, in which the early generation of hypotheses influences the subsequent gathering of information. This article comments briefly on research on the mental process by which medical problems are solved. It describes the methods that research has shown to be most applicable in instruction to develop problem-solving abilities, and presents some educational principles that justify their application. The "trail-following" approach is the method that has been most commonly used to study the physician's problem-solving behavior. The salient conclusions from this research are that in the problem-solving process the diagnostic hypothesis is generated very early on and with limited data; the number of hypotheses is small; the problem-solving approach is specific to the type of medical problem and case in hand; and the accumulation of medical knowledge and experience forms the basis of clinical competence. Four methods for teaching the solution of problems are described: case presentation, the rain of ideas, the nominal groups technique and decision-making consensus, the census and analysis of forces in the field, and the analysis of clinical decisions. These methods are carried out in small groups. The advantages of the small groups are that the students are active participants in the learning process, they receive formative evaluation of their performance in a setting conductive to learning, and are able to interact with their instructor if he makes proper use of the right questioning techniques. While no single problem-solving method can be useful to all students or in all the problems they encounter, teachers of medicine can improve their students' performance by adjusting these available methods to their particular needs and to those of their schools. The problem-solving methods described can help teachers shape the learning environment so as to develop in their students the most coherent, logical, concrete and complete set of skills possible. These methods can so be of value in improving the training of future doctors and the quality of their decisions to the benefit of their patients.
The recent literature on social skills training has placed an increasing emphasis on the role of cognitive factors in social failure, as opposed to deficits in motoric skills. It has been hypothesized that schizophrenic patients are markedly deficient in social problem-solving abilities, and several programs have been developed to teach problem-solving skills. Despite high face validity, there is little empirical support for these training programs or the problem-solving model on which they are based. Research on information processing and problem solving in nonpatient populations is discussed, and it is concluded that the model used in these treatment programs is not a good representation of the problem-solving process. In particular, means-ends analysis is not an appropriate strategy for dealing with most interpersonal problems and conflicts. The difficulties experienced by schizophrenic patients in social situations might be due to a number of factors other than deficits in problem-solving skill, including sensitivity to negative affect and disordered communication. It is concluded that further research on problem-solving training programs is clearly warranted but that the validity of the problem-solving model and the utility of the training is uncertain.
When managers confront complex problems, their attitudes toward problem solving affect their behavior. The problem-solving attitudes of over 100 women and men who manage six hospitals are analyzed.
Interpersonal problem-solving skills of 17 mildly mentally retarded and two groups of nonretarded subjects (Ns = 30) matched on mental age (MA) and chronological age (CA) were assessed, utilizing a series of hypothetical problem-solving situations. Results indicated similarities between mentally retarded subjects and MA-matched nonretarded subjects both in types and number of strategies produced. Nonretarded CA-matched subjects, on the other hand, exhibited a wider range of problem-solving strategies and increased use of strategies thought to reflect higher levels of social understanding.
A collaborative problem-solving system committed to the interests of those involved complies with the teachings of the total quality management movement in health care. Deming espoused that any quality system must become an integral part of routine activities. A process that is used consistently in dealing with problems, issues, or conflicts provides a mechanism for accomplishing total quality improvement. The collaborative problem-solving process described here results in quality decision-making. This model incorporates Ishikawa's cause-and-effect (fishbone) diagram, Moore's key causes of conflict, and the steps of the University of North Dakota Conflict Resolution Center's collaborative problem solving model.
Hospitalized psychiatric patients frequently have deficits in their problem-solving abilities. An inpatient problem-solving group provides a therapeutic experience in which patients learn and apply the problem-solving process to practical and interpersonal difficulties they are presently experiencing. Two problem-solving group models, derived from cognitive-behavior theory, are suggested to accommodate diverse levels of inpatient functioning. Implications for nursing practice and recommendations are addressed.
OBJECTIVE: To determine whether, in the treatment of major depression in primary care, a brief psychological treatment (problem solving) was (a) as effective as antidepressant drugs and more effective than placebo; (b) feasible in practice; and (c) acceptable to patients. DESIGN: Randomised controlled trial of problem solving treatment, amitriptyline plus standard clinical management, and drug placebo plus standard clinical management. Each treatment was delivered in six sessions over 12 weeks. SETTING: Primary care in Oxfordshire. SUBJECTS: 91 patients in primary care who had major depression. MAIN OUTCOME MEASURES: Observer and self reported measures of severity of depression, self reported measure of social outcome, and observer measure of psychological symptoms at six and 12 weeks; self reported measure of patient satisfaction at 12 weeks. Numbers of patients recovered at six and 12 weeks. RESULTS: At six and 12 weeks the difference in score on the Hamilton rating scale for depression between problem solving and placebo treatments was significant (5.3 (95% confidence interval 1.6 to 9.0) and 4.7 (0.4 to 9.0) respectively), but the difference between problem solving and amitriptyline was not significant (1.8 (-1.8 to 5.5) and 0.9 (-3.3 to 5.2) respectively). At 12 weeks 60% (18/30) of patients given problem solving treatment had recovered on the Hamilton scale compared with 52% (16/31) given amitriptyline and 27% (8/30) given placebo. Patients were satisfied with problem solving treatment; all patients who completed treatment (28/30) rated the treatment as helpful or very helpful. The six sessions of problem solving treatment totalled a mean therapy time of 3 1/2 hours. CONCLUSIONS: As a treatment for major depression in primary care, problem solving treatment is effective, feasible, and acceptable to patients.
An organized radiologic problem-solving system is presented for developing improved view box exercises for students and residents. It is based on six components: (1) problem sensing, (2) problem hypothesizing, (3) problem searching and definition, (4) problem identification, (5) resolution, and (6) verification. Since all examinations by the practicing radiologist involve these components, worthwhile simulated clinical management games should also incorporate them. A simulated radiologic exercise should be a valid measurement of the resident's ability to manage a wide range of clinical situations and techniques and should improve problem-solving strategies. Use of simulated clinical cases eliminates risk to patients during the educational process.
In the study reported here, the authors assessed the use of efficient organization of knowledge and of problem-solving strategies to enhance medical students' clinical problem-solving skills. Thirty-five preclinical medical students were randomly assigned to a experimental or control group and given a knowledge base containing information on eight congenital heart diseases to learn. Information for the experimental group emphasized disease groupings (based on their similar clinical presentation), symptom-disease associations, and clinical problem-solving heuristics. The same information for the control group was presented in a textbook format that emphasized the pathophysiology of the diseases. The students then diagnosed three computerized diagnostic problems of varying difficulty while verbalizing their problem-solving strategies. The results showed that the experimental group acquired a higher ratio of diagnostic to nondiagnostic cues, mentioned the correct diagnosis sooner in their workups, and correctly diagnosed the most difficult case more often than the control group. These results provide support for revisions in the organization and presentation of information that are aimed at improving clinical problem-solving skills.
The study investigated problem solving ability in schizophrenia. Thirty DSM-IIIR schizophrenic patients and 27 matched normal controls were tested on the Three-Dimensional Computerised Tower of London Test (3-D CTL Test) (Morris et al., 1993). The patients took significantly more moves to solve a series of problems and solved significantly fewer problems in the predetermined minimum number of moves. The patients response times, as measured using a control version of the task (the 3-D CTL Control), were longer than those of the controls. However, when latencies were adjusted to take into account the slower responses overall, the patients planning times were not significantly increased. Inaccurate planning, as defined by taking more moves, did not correlate with either positive or negative symptoms, but the response times tended to be longer in patients who had more negative symptoms. The findings suggest that there is a deficit in problem solving activity in schizophrenia that may be associated with translating 'willed intentions' into action, independent of slower motor speed.
Although a mother's perception of her competence in problem-solving issues of infant care may affect her sensitivity to her infant's cues, little is known about factors that contribute to this perception. This study explored the type of information on which maternal confidence is based and examined its relationship to perceived competence in problem-solving issues of infant care. The 49 mothers of healthy newborns who participated in this study were interviewed 30 and 90 days after the infant's birth to learn about sources of confidence or uncertainty. The interview protocol also included scaled items to assess perceived problem-solving competence. The infant's mood was most frequently reported as either a source of confidence or uncertainty at both 30 and 90 days. The infant's response to care as a source of confidence or uncertainty was positively related to perceived competence, suggesting that strengthening mothers' attention to this source of information about their performance may be clinically useful. Direct study of the type of information used to evaluate competence in problem-solving is recommended, since it may differ from the type of information on which mothers base their confidence in caring for their infants.
This study examined the impact of social problem-solving training on the behavior of five aggressive boys. Acquisition of problem-solving skills and changes in classroom behavior were evaluated using multiple-baseline designs within and across subjects. A generalization-programming procedure to promote the use of problem-solving skills in the natural environment was introduced across children in multiple-baseline fashion. Direct observation and behavior ratings were used to evaluate the treatment. Results indicated that each subject acquired the problem-solving skills at levels comparable to well-adjusted peers. Only one child showed behavioral improvement coincident with problem-solving skill acquisition. Three others showed moderate behavior change after the generalization-programming procedure was introduced. Only one child's gains on teacher ratings were maintained at the 6-month followup. The results suggest that cognitive-behavioral treatment of childrens' aggressive behavior may produce changes of limited magnitude and durability.
We present a control theory analysis of adolescents' attachment strategies in the Adult Attachment Interview (AAI). In Study 1, Q-sort prototypes for secure/anxious and deactivating/hyperactivating strategies were used to differentiate between Main and Goldwyn's AAI classifications. In Study 2, we examined how AAI strategies were associated with emotion regulation during mother-teen problem solving. 4 aspects of mother-teen problem solving (dysfunctional anger, support/validation, avoidance of problem solving, and maternal dominance) were used to predict teens' AAI strategies. Teens with secure strategies engaged in problem-solving discussions characterized by less dysfunctional anger and less avoidance of problem solving. In addition, attachment security showed a curvilinear relation with maternal dominance, indicating that secure teens maintained balanced assertiveness with their mothers. Teens with deactivating strategies engaged in problem-solving interactions characterized by higher levels of maternal dominance and dysfunctional anger. The contribution of attachment strategies to teens' autonomy and to transformations in mother-teen relationships is discussed.
The advent of the laparoscopic revolution and the wider applicability of laparoscopic procedures has caused surgeons to re-think the dynamics of intraoperative problem-solving. Problems of body habitus, previous surgery, exposure, bleeding, and anesthesia, as well as the problem cholangiogram, require new and innovative approaches, a practical approach to each of these common laparoscopic problems is presented.