Clinical Reasoning Tasks and Resident Physicians: What Do They Reason About? - PubMed
This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features!
Clipboard, Search History, and several other advanced features are temporarily unavailable.
Skip to main page content
An official website of the United States government
Here's how you know
The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before
sharing sensitive information, make sure you’re on a federal
government site.
The site is secure.
The https:// ensures that you are connecting to the
official website and that any information you provide is encrypted
and transmitted securely.
Log in
Show account info
Close
Account
Logged in as:
username
Dashboard
Publications
Account settings
Log out
Access keys
NCBI Homepage
MyNCBI Homepage
Main Content
Main Navigation
Search:
Search
Advanced
Clipboard
User Guide
Save
Email
Send to
Clipboard
My Bibliography
Collections
Citation manager
Display options
Display options
Format
Abstract
PubMed
PMID
Save citation to file
Format:
Summary (text)
PubMed
PMID
Abstract (text)
CSV
Create file
Cancel
Email citation
Email address has not been verified. Go to
My NCBI account settings
to confirm your email and then refresh this page.
To:
Subject:
Body:
Format:
Summary
Summary (text)
Abstract
Abstract (text)
MeSH and other data
Send email
Cancel
Add to Collections
Create a new collection
Add to an existing collection
Name your collection:
Name must be less than 100 characters
Choose a collection:
Unable to load your collection due to an error
Please try again
Add
Cancel
Add to My Bibliography
My Bibliography
Unable to load your delegates due to an error
Please try again
Add
Cancel
Your saved search
Name of saved search:
Search terms:
Test search terms
Would you like email updates of new search results?
Saved Search Alert Radio Buttons
Yes
No
Email:
(change)
Frequency:
Monthly
Weekly
Daily
Which day?
The first Sunday
The first Monday
The first Tuesday
The first Wednesday
The first Thursday
The first Friday
The first Saturday
The first day
The first weekday
Which day?
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Report format:
Summary
Summary (text)
Abstract
Abstract (text)
PubMed
Send at most:
1 item
5 items
10 items
20 items
50 items
100 items
200 items
Send even when there aren't any new results
Optional text in email:
Save
Cancel
Create a file for external citation management software
Create file
Cancel
Your RSS Feed
Name of RSS Feed:
Number of items displayed:
5
10
15
20
50
100
Create RSS
Cancel
RSS Link
Copy
Full text links
Silverchair Information Systems
Full text links
Actions
Cite
Collections
Add to Collections
Create a new collection
Add to an existing collection
Name your collection:
Name must be less than 100 characters
Choose a collection:
Unable to load your collection due to an error
Please try again
Add
Cancel
Permalink
Permalink
Copy
Display options
Display options
Format
AbstractPubMedPMID
Page navigation
Title & authors
Abstract
Comment in
Publication types
MeSH terms
LinkOut - more resources
Title & authors
Abstract
Comment in
Publication types
MeSH terms
LinkOut - more resources
Acad Med
Actions
Search in PubMed
Search in NLM Catalog
Add to Search
. 2016 Jul;91(7):1022-8.
doi: 10.1097/ACM.0000000000001024.
Clinical Reasoning Tasks and Resident Physicians: What Do They Reason About?
Elexis McBee 
1
, Temple Ratcliffe, Mark Goldszmidt, Lambert Schuwirth, Katherine Picho, Anthony R Artino Jr, Jennifer Masel, Steven J Durning
Affiliations
Expand
Affiliation
1 E. McBee is assistant professor of medicine, Uniformed Services University of the Health Sciences, based at Naval Medical Center San Diego, San Diego, California. T. Ratcliffe is assistant professor of medicine, University of Texas Health Science Center, San Antonio, Texas. M. Goldszmidt is associate professor of medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. L. Schuwirth is professor of medicine, Flinders University, Adelaide, Australia. K. Picho is assistant professor of medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland. A.R. Artino Jr is associate professor of preventive medicine and biometrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland. J. Masel is third-year resident, Walter Reed National Military Medical Center, Bethesda, Maryland. S.J. Durning is professor of medicine and pathology, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
PMID:
26650677
DOI:
10.1097/ACM.0000000000001024
Item in Clipboard
Clinical Reasoning Tasks and Resident Physicians: What Do They Reason About?
Elexis McBee et al.
Acad Med.
2016 Jul.
Show details
Display options
Display options
Format
Abstract
PubMed
PMID
Acad Med
Actions
Search in PubMed
Search in NLM Catalog
Add to Search
. 2016 Jul;91(7):1022-8.
doi: 10.1097/ACM.0000000000001024.
Authors
Elexis McBee 
1
, Temple Ratcliffe, Mark Goldszmidt, Lambert Schuwirth, Katherine Picho, Anthony R Artino Jr, Jennifer Masel, Steven J Durning
Affiliation
1 E. McBee is assistant professor of medicine, Uniformed Services University of the Health Sciences, based at Naval Medical Center San Diego, San Diego, California. T. Ratcliffe is assistant professor of medicine, University of Texas Health Science Center, San Antonio, Texas. M. Goldszmidt is associate professor of medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. L. Schuwirth is professor of medicine, Flinders University, Adelaide, Australia. K. Picho is assistant professor of medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland. A.R. Artino Jr is associate professor of preventive medicine and biometrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland. J. Masel is third-year resident, Walter Reed National Military Medical Center, Bethesda, Maryland. S.J. Durning is professor of medicine and pathology, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
PMID:
26650677
DOI:
10.1097/ACM.0000000000001024
Item in Clipboard
Full text links
Cite
Display options
Display options
Format
AbstractPubMedPMID
Abstract
Purpose:
A framework of clinical reasoning tasks thought to occur in a clinical encounter was recently developed. It proposes that diagnostic and therapeutic reasoning comprise 24 tasks. The authors of this current study used this framework to investigate what internal medicine residents reason about when they approach straightforward clinical cases.
Method:
Participants viewed three video-recorded clinical encounters portraying common diagnoses. After each video, participants completed a post encounter form and think-aloud protocol. Two authors analyzed transcripts from the think-aloud protocols using a constant comparative approach. They conducted iterative coding of the utterances, classifying each according to the framework of clinical reasoning tasks. They evaluated the type, number, and sequence of tasks the residents used.
Results:
Ten residents participated in the study in 2013-2014. Across all three cases, the residents employed 14 clinical reasoning tasks. Nearly all coded tasks were associated with framing the encounter or diagnosis. The order in which residents used specific tasks varied. The average number of tasks used per case was as follows: Case 1, 4.4 (range 1-10); Case 2, 4.6 (range 1-6); and Case 3, 4.7 (range 1-7). The residents used some tasks repeatedly; the average number of task utterances was 11.6, 13.2, and 14.7 for, respectively, Case 1, 2, and 3.
Conclusions:
Results suggest that the use of clinical reasoning tasks occurs in a varied, not sequential, process. The authors provide suggestions for strengthening the framework to more fully encompass the spectrum of reasoning tasks that occur in residents' clinical encounters.
PubMed Disclaimer
Comment in
Clinical Reasoning and Threshold Concepts.
Ma C, Tabarsi N, Chen L.
Ma C, et al.
Acad Med. 2017 Apr;92(4):426. doi: 10.1097/ACM.0000000000001587.
Acad Med. 2017.
PMID: 28350592
No abstract available.
In Reply to Ma et al.
McBee E, Schuwirth L, Durning SJ.
McBee E, et al.
Acad Med. 2017 Apr;92(4):426-427. doi: 10.1097/ACM.0000000000001615.
Acad Med. 2017.
PMID: 28350593
No abstract available.
Publication types
Research Support, Non-U.S. Gov't
Actions
Search in PubMed
Search in MeSH
Add to Search
MeSH terms
California
Actions
Search in PubMed
Search in MeSH
Add to Search
Clinical Decision-Making*
Actions
Search in PubMed
Search in MeSH
Add to Search
Female
Actions
Search in PubMed
Search in MeSH
Add to Search
Humans
Actions
Search in PubMed
Search in MeSH
Add to Search
Internal Medicine / education*
Actions
Search in PubMed
Search in MeSH
Add to Search
Internship and Residency*
Actions
Search in PubMed
Search in MeSH
Add to Search
Male
Actions
Search in PubMed
Search in MeSH
Add to Search
Physicians / psychology*
Actions
Search in PubMed
Search in MeSH
Add to Search
Thinking*
Actions
Search in PubMed
Search in MeSH
Add to Search
Video Recording
Actions
Search in PubMed
Search in MeSH
Add to Search
LinkOut - more resources
Full Text Sources
Ingenta plc
Ovid Technologies, Inc.
Silverchair Information Systems
Other Literature Sources
scite Smart Citations
Full text links
[x]
Silverchair Information Systems
[x]
Cite
Copy
Download .nbib
.nbib
Format:
AMA
APA
MLA
NLM
Send To
Clipboard
Email
Save
My Bibliography
Collections
Citation Manager
[x]
NCBI Literature Resources
MeSH
PMC
Bookshelf
Disclaimer
The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.
Follow NCBI
Twitter
Facebook
LinkedIn
GitHub
Connect with NLM
Twitter
SM-Facebook
SM-Youtube
National Library of Medicine
8600 Rockville Pike
Bethesda, MD 20894
Web Policies
FOIA
HHS Vulnerability Disclosure
Help
Accessibility
Careers
NLM
NIH
HHS
USA.gov