The aging physician: Changes in cognitive processing and their impact on medical practice

Academic Medicine

Volumn 77, Issue 10 SUPPL., 2002, Pages

  Eva, Kevin W ^a  

^a MCMASTER UNIVERSITY   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

ACCREDITATION; AGE; CERTIFICATION; CLINICAL PRACTICE; COGNITION; COMPETENCE; COMPREHENSION; CONTINUING EDUCATION; DIAGNOSTIC ACCURACY; EXPERIENCE; HUMAN; JOB PERFORMANCE; MEDICAL EDUCATION; MEDICAL PRACTICE; MEDICAL SOCIETY; MEMORY; NEUROPSYCHOLOGICAL TEST; ORGANIZATION; PREDICTION; PRIORITY JOURNAL; REVIEW; SCORING SYSTEM; SKILL;

EID: 0036795348     PISSN: 10402446     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001888-200210001-00002     Document Type: Review

References (76)

1. Health Canada. Division of Aging and Seniors, (http://www.hc-sc.gc.ca/seniorsaines/pubs/fpt_docs/fed_paper/fral_O1_e.htm). Accessed 8/21/02.
2. United Nations. United Nations Population Division Homepage, (http://www.un.org/esa/population/unpop.htm). Accessed 8/21/02.
3. Reagan PA, Brookins-Fisher J. Community Health in the 21st Century. San Francisco, CA: Benjamin-Cummings, 2002.
4. Kralj B. Physician human resources in Ontario: the crisis continues. Ont Med Rev. 2001;68:19-28.
5. Ontario Physician Human Resources Data Centre. Physicians in Ontario. McMaster University, Hamilton, ON. [Various years]
6. Page GG, Bates J, Dyer SM, et al. Physician-assessment and physician enhancement programs in Canada. Can Med Assoc J. 1995;153:1723-8.
7. Cunnington JPW, Keane D. The Physician Review Program (PREP). Pedagogue 1996-1997;7:1,3-6.
8. Southgate L, Cox J, David T, et al. The assessment of poorly performing doctors: the development of the assessment programmes for the General Medical Council's performance procedures. Med Educ. 2001;35(1 suppl):S2-S8.
9. Southgate L, Cox J, David T, et al. The General Medical Council's performance procedures: peer review of performance in the workplace. Med Educ. 2001;35(1 suppl):S9-S19.
10. Aring CD. Recertification. JAMA. 1975;233:1063-4.
11. Meskauskas JA, Webster GD. The American Board of Internal Medicine Recertification Examination: process and results. Ann Intern Med. 1975;82:1-5.
12. Davis DA, Norman GR, Painvin A, Lindsay E, Ragbeer MS, Rath D. Attempting to ensure physician competence. JAMA. 1990;263:2041-2.
13. Cunnington JPW, Hanna E, Turnbull J, Kaiga TB, Norman GR. Defensible assessment of the competency of the practicing physician. Acad Med. 1997;72:9-12
14. Turnbull J, Carbotte R, Hanna E, et al. Cognitive difficulty in physicians. Acad Med. 2000;75:177-81.
15. Norman GR, Davis DA, Lamb S, Hanna E, Caulford P, Kaigas T. Competency assessment of primary care physicians as part of a peer-review program. JAMA. 1993;270:1046-51.
16. McAuley RG, Henderson HW. Results of the peer assessment program of the College of Physicians and Surgeons of Ontario. Can Med Assoc J. 1984;131:557-61.
17. Norcini JJ, Lipner RS, Benson JA, Webster GD. An analysis of the knowledge base of practicing intemists as measured by the 1980 recertification examination. Ann Intern Med. 1985;102:385-9.
18. Sample L, LaDuca T, Leung C, et al. Comparing patient-management skills of referred physicians and non-referred physicians on a computer-based case-simulation examination. Acad Med. 2001;76 (10 suppl):S24-S26.
19. Day SC, Norcini JJ, Webster GD, Viner ED, Chirico AM. The effect of changes in medical knowledge on examination performance at the time of recertification. Proc Annu Conf Res Med Educ. 1988;27:139-44.
20. Caulford PG, Lamb SB, Kaigas TB, et al. Physician incompetence: specific problems and predictors. Acad Med. 1994;69(10 suppl):S16-S18.
21. Custers EJFM, Regehr G, Norman GR. Mental representations of medical diagnostic knowledge: a review. Acad Med. 1996;71(10 suppl):S55-S61.
22. Norman GR, Brooks LR. The non-analytical basis of clinical reasoning. Adv Health Sci Educ. 1997;2:173-84.
23. Hobus PPM, Schmidt HG, Boshuizen HPA, Patel VL. Contextual factors in the activation of first diagnostic hypotheses: Expert-novice differences. Med Educ. 1987;21:471-6.
24. Hobus PPM, Schmidt HG. 1993. In: Schmidt HG. The encapsulation framework in the presentation of physicians' recall of clinical cases. Presented at the annual meeting of the American Educational Research Association. Seattle, WA, 2001.
25. Barrows HS, Norman GR, Neufeld VR, Feightner JW. The clinical reasoning of randomly selected physicians in general medical practice. Clin Invest Med. 1982;5:49-55.
26. Norman GR, Rosenthal D, Brooks LR, Alien SW, Muzzin LJ. The development of expertise in dermatology. Arch Dermatol. 1989;125:1063-8.
27. Elstein AS, Shulman LS, Sprafka SA. Medical Problem Solving: An Analysis of Clinical Reasoning, Cambridge, MA: Harvard University Press, 1978.
28. Groen GJ, Patel VL. Medical problem-solving: some questionable assumptions. Med Educ. 1985;19:95-100.
29. Bordage G, Zacks R. The structure of medical knowledge in memories of medical students and practitioners: categories and prototypes. Med Educ. 1984;18:406-16.
30. Gale J, Marsden P. Medical Diagnosis from Student to Clinician. Oxford, U.K.: Oxford University Press, 1983.
31. Regehr G, Brooks LR. Perceptual manifestations of an analytic structure: the priority of holistic individuation. J Exp Psychol Gen. 1993;1222:92-114.
32. Regehr G, Cline J, Norman GR, Brooks L. Effect of processing strategy on diagnostic skill in dermatology. Acad Med. 1994;69(10 suppl):S34-S36.
33. Regehr G, Brooks L, Norman GR, Cline C, Whittlesea B. Coordinating analytic and episodic processes in visually based medical diagnosis. [Unpublished].
34. Dreyfus HL, Dreyfus SE. Why skills cannot be represented in rules. In: Starkey NE (ed). Advances in Cognitive Science. Chichester, U.K.: Ellis Horwood, 1986:315-35.
35. Schmidt HG, Boshuizen HPA. On acquiring expertise in medicine. Educ Psychol Rev. 1993;5:205-21.
36. Schmidt HG, Norman GR, Boshuizen HPA. A cognitive perspective on medical expertise: theory and implications. Acad Med. 1990;65:611-21.
37. Craik FIM, Jennings JM. Human memory. In Craik FIM, Salrhouse TA (eds). The Handbook of Aging and Cognition. Hillsdale, NJ: Erlbaum, 1992.
38. Tulving E, Craik FIM (eds). The Oxford Handbook of Memory. New York: Oxford University Press, 2000.
39. Jacoby LL. A process dissociation framework: separating automatic from intentional uses of memory. J Mem Language. 1991;30:513-41.
40. Hay JF, Jacoby LL. Separating habit and recollection in young and older adults: effects of elaborative processing and distinctiveness. Psych Aging. 1999;14:122-34.
41. Jacoby LL, Jennings JM, Hay JF. Dissociating automatic and consciously controlled processes: implications for diagnosis and rehabilitation of memory deficits. In: Herrman DJ, McEvoy CL, Hertzog C, Hertel P, Johnson MK (eds). Basic and Applied Memory Research: Theory in Context. Mahwah, NJ: Erlbaum, 1998.
42. Dywan J, Jacoby LL. Effects of aging on source monitoring: differences in susceptibility to false fame. Psychol Aging. 1990;5:379-87.
43. Jacoby LL, Kelley C, McElree BD. The role of cognitive control: early selection versus late correction. In: Chaiken S, Trope Y (eds). Dual Process Theories in Social Psychology. New York: Guilford, 1999.
44. Eva KW, Norman GR, Neville AJ, Wood TJ, Brooks LR. Expert/Novice Differences in Memory: A Reformulation. [Unpublished].
45. Schmidt HG, Boshuizen HPA. On the origin of the intermediate effects in clinical case recall. Memory and Cognition. 1993;21:338-51.
46. Reyna VF, Brainerd CJ. Fuzz trace theory: an interim thesis. Learn Individ Diff. 1995;7:1-75.
47. Koutstaal W, Schacter DL. Gist-based false recognition of pictures in older and younger adults. J Mem Language. 1997;37:555-83.
48. Park DC, Cognitive aging, processing resources, and self-report. In: Schwarz N, Park DC, Knauper B, Sudman S (eds). Cognition, Aging, and Self-Reports. Philadelphia, PA: Psychology Press, 1999.
49. Schaie KW. Intellectual Development in Adulthood: The Seattle Longitudinal Study. New York: Cambridge University Press, 1996.
50. Van der Lindan M, Bredart S, Beerten A. Age-related differences in updating working memory. Br J Psychol. 2000;85:145-52.
51. Kray J, Lindenberger U. Adult age differences in task switching. Psychol Aging. 2000;15:126-47.
52. Sciafa CT, Ho G, McPhee L, Dennis W. Age differences in triple conjunction visual search. Paper presented at the annual meeting of the Canadian Society for Brain, Behavior, and Cognitive Science. Laval, Quebec, Canada, 2001.
53. Collins B, Tellier A. Differences in conceptual flexibility with age as measured by a modified version of the Visual Verbal Test. Can J Aging. 1994;13:368-77.
54. Hartman M, Bolton E, Fehnel SE. Accounting for age differences on the Wisconsin Card Sorting Test: decreased working memory, not inflexibility. Psychol Aging. 2001:16;385-99.
55. Cunnington JPW, Turnbull JM, Regehr G, Marriott M, Norman GR. The effect of presentation order in clinical decision making. Acad Med. 1997;72(10 suppl):S40-S42.
56. Klaczynski PA, Robinson B. Personal theories, intellectual ability, and epistemological beliefs: adult age differences in everyday reasoning biases. Psychol Aging. 2000;5:400-16.
57. Obler LK, Fein D, Nicholas M, Albert ML. Auditory comprehension and aging: decline in synctactic processing. Appl Psycholinguistics. 1991;12:433-52.
58. Wingfield A. Comprehending spoken questions: effects of cognitive and sensory change in adult aging. In: Schwarz N, Park DC, Knauper B, Sudman (eds). Cognition, Aging, and Self-Reports. Philadelphia, PA: Psychology Press, 1999.
59. Laver GD, Burke DM. Why do semantic priming effects increase in old age? A meta-analysis. Psychol Aging. 1993;8:34-43.
60. Speranza F, Daneman M, Schneider BA. How aging affects the reading of words in noisy backgrounds. Psychol Aging. 2000;15:253-8.
61. Pichora-Fuller K, Schneider BA, Daneman M. How young and old adults listen to and remember speech in noise. J Acoustic Soc Am. 1995;97:593-608.
62. Baltes PB, Lindenberger U. Emergence of powerful connection between sensory and cognitive functions across the adult lifespan: a new window to the study of cognitive aging? Psychol Aging. 1997;12:12-21.
63. Lindenberger U, Baltes PB. Sensory functioning and intelligence in old age: a strong connection. Psychol Aging. 1994;9:339-55.
64. Gilmore GC, Thomas CW, Klitz T, Persanyi MW, Tomsak R. Contrast enhancement eliminates letter identification speed deficits in Alzheimer's disease. J Clin Geropsychol. 1996;2:307-20.
65. Salthouse TA. Age and experience effects on the interpretation of orthographic drawings of three-dimensional objects. Psychol Aging. 1991;6:426-33.
66. Tsang PS, Shaner TL. Age, attention, expertise, and time-sharing performance. Psychol Aging. 1998;3:323-47.
67. Meinz EJ, Salthouse TA. The effects of age and experience on memory for visually presented music. J Gerontol Psychol Sci. 1998;53B:60-9.
68. Masunaga H, Horn J. Expertise and age-related changes in components of intelligence. Psychol Aging. 2001;16:293-311.
69. Ericsson KA, Charness N. Expert performance: its structure and acquisition. Am Psychologist. 1994;49:725-47.
70. Norman GR, Brooks LR, Colle CL, Hatala RM. The benefit of diagnostic hypotheses in clinical reasoning: experimental study of an instructional intervention for forward and backward reasoning. Cogn Instruct. 2000;17:433-48.
71. Lockyer JM. Physician performance: the roles of knowledge, skill, and environment. Teach Learn Med. 1992;4:86-6.
72. Eva KW. The influence of differentially processing information on diagnostic decision-making [dissertation]. McMaster University, Hamilton, Ontario, Canada, 2001.
73. Lindenberger U, Marsiske M, Baltes PB. Memorizing while walking: increase in dual-task costs from young adulthood to old age. Psychol Aging. 2000;15:417-36.
74. Hamstra SD. Technical skills training in surgery: transfer of learning and the specification of essential constructs. Presented at McMaster University, February 20, 2002.
75. Guest CB, Regehr G, Tiberius RG. The lifelong challenge of expertise. Med Educ. 2001;35:78-81.
76. Eva KW. Assessing tutorial-based assessment. Adv Health Sci Educ. 2001;6:233-46.