Diagnostic thinking and information used in clinical decision-making: A qualitative study of expert and student dental clinicians

BMC Oral Health

Volumn 10, Issue 1, 2010, Pages

  Maupomé, Gerardo ^a,b   Schrader, Stuart ^a   Mannan, Saurabh ^c   Garetto, Lawrence ^a   Eggertsson, Hafsteinn ^a  

^a INDIANA UNIVERSITY SCHOOL OF DENTISTRY   (United States)

^b REGENSTRIEF INSTITUTE   (United States)

^c UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CHI SQUARE DISTRIBUTION; CLINICAL COMPETENCE; COMPARATIVE STUDY; CONCEPT FORMATION; DECISION MAKING; DENTAL CARIES; DENTAL STUDENT; DENTIST; FEMALE; HUMAN; MALE; OBSERVER VARIATION; PSYCHOLOGICAL ASPECT; PSYCHOLOGICAL MODEL; QUALITATIVE RESEARCH; TEACHING; TOOTH FRACTURE; TOOTH RADIOGRAPHY;

CHI-SQUARE DISTRIBUTION; CLINICAL COMPETENCE; CONCEPT FORMATION; DECISION MAKING; DENTAL CARIES; DENTISTS; FEMALE; HUMANS; MALE; MODELS, PSYCHOLOGICAL; OBSERVER VARIATION; PATIENT SIMULATION; QUALITATIVE RESEARCH; RADIOGRAPHY, DENTAL; STUDENTS, DENTAL; TOOTH FRACTURES;

EID: 77952076831     PISSN: None     EISSN: 14726831     Source Type: Journal    
DOI: 10.1186/1472-6831-10-11     Document Type: Article

References (65)

1. Barrows HS. Problem-Based Learning. An Approach to Medical Education 1980, Springer. New York, NY.
2. Barrows HS. The clinical reasoning of randomly selected physicians in general medical practice. Clin Invest Med 1982, 5:49-55.
3. Elstein AS, Shulman LS, Sprafka SA. Medical Problem Solving: An Analysis of Clinical Reasoning 1978, Cambridge, MA. Harvard University Press.
4. Grembowski D, Milgrom P, Fiset L. Dental decision-making and variation in dentist service rates. Soc Sci Med 1991, 32(3):287-94. 10.1016/0277-9536(91)90106-M, 2024138.
5. Bader JD, Shugars DA. Agreement among dentists' recommendations for restorative treatment. J Dent Res 1993, 72(5):891-6.
6. Bader JD, Shugars DA. Variation in dentists' clinical decisions. J Publ Health Dent 1995, 55(3):181-8.
7. Brantley CF, Bader JD, Shugars DA, Nesbit SP. Does the cycle of rerestoration lead to larger restorations?. J Am Dent Assoc 1995, 126:1407-13.
8. Shugars DA, Bader JD. Practice parameters in dentistry: where do we stand?. J Am Dent Assoc 1995, 126:1134-43.
9. Maupome G, Sheiham A. Clinical decision-making in restorative dentistry. Content-analysis of diagnostic thinking processes and concurrent concepts used in an educational environment. Eur J Dent Educ 2000, 4:143-152. 10.1034/j.1600-0579.2000.040401.x, 11168479.
10. Maupomé G, Sheiham A. Explanatory models in the interpretations of clinical features of dental patients within a university Dental Education setting. Eur J Dent Educ 2002, 6(1):2-8. 10.1034/j.1600-0579.2002.060102.x, 11872067.
11. Crespo K, Torres JE, Recio ME. Reasoning process characteristics in the diagnostic skills of beginner, competent, and expert dentists. J Dent Educ 2004, 68(12):1235-44.
12. Merrett MCW, Elderton RJ. An in vitro study of restorative dental treatment decisions and dental caries. Br Dent J 1984, 157:128-33. 10.1038/sj.bdj.4805448, 6591943.
13. Cleaton-Jones P, Hargreaves JA, Fatti LP, Chandler HD, Grossman ES. Dental caries diagnosis calibration for clinical field surveys. Caries Res 1989, 23:195-9. 10.1159/000261177, 2736583.
14. Elderton RJ, Nuttall NM. Variation among dentists in planning treatment. Br Dent J 1983, 154:201-6. 10.1038/sj.bdj.4805041, 6573898.
15. Hendricson WD, Andrieu SC, Chadwick DG, Chmar JE, Cole JR, George MC, Glickman GN, Glover JF, Goldberg JS, Haden NK, Meyerowitz C, Neumann L, Pyle M, Tedesco LA, Valachovic RW, Weaver RG, Winder RL, Young SK, Kalkwarf KL. ADEA Commission on Change & Innovation in Dental Education Educational strategies associated with development of problem-solving, critical thinking, and self-directed learning. J Dent Educ 2006, 70(9):925-936. ADEA Commission on Change & Innovation in Dental Education.
16. Crawford JM, Adami G, Johnson BR, Knight GW, Knoernschild K, Obrez A, Patston PA, Punwani I, Zaki AM, Licari FW. Curriculum restructuring at a North American dental school: Rationale for change. J Dent Educ 2007, 71(4):524-531.
17. Benner P. Taking a stand on experiential learning and good practice. Am J Crit Care 2001, 10:60-62.
18. Flack VF, Atchison KA, Hewlett ER, White SC. Relationships between clinician variability and radiographic guidelines. J Dent Res 1996, 75(2):775-82. 10.1177/00220345960750020701, 8655774.
19. Espelid I. Radiographic diagnoses and treatment decisions on approximal caries. Community Dent Oral Epidemiol 1986, 14:265-70. 10.1111/j.1600-0528.1986.tb01069.x, 3466745.
20. Kay EJ, Nuttall NM. Relationship between dentists' treatment attitudes and restorative decisions made on the basis of simulated bitewing radiographs. Community Dent Oral Epidemiol 1994, 22:71-4. 10.1111/j.1600-0528.1994.tb01575.x, 8205782.
21. Bader JD, Shugars DA. What do we know about how dentists make caries-related treatment decisions?. Community Dent Oral Epidemiol 1997, 25:97-103. 10.1111/j.1600-0528.1997.tb00905.x, 9088698.
22. Barrows HS. Keynote Address: Problem-based Learning in Medicine. Aspects of Educational Technology 10: Individualized Learning 1976, Philadelphia PA: Kogan Page, Clarke J, Leedham J.
23. Reitman WR. Heuristic Decision Procedures, Open Constraints and the Structure of Ill- Defined Problems. Human Judgements and Optimality 1964, John Hoboken NJ: Wiley and Sons, Shelley MW, Bryan GL.
24. Hoffman PJ. The paramorphic representation of clinical judgement. Psychol Bull 1960, 57:116-31. 10.1037/h0047807, 14402414.
25. Ledley RS, Lusted LB. Reasoning foundations of medical diagnosis. Science 1959, 130:9-21. 10.1126/science.130.3366.9, 13668531.
26. Hammond KR, Summers DA. Cognitive dependence on linear and non-linear cues. Psychol Rev 1965, 72:215-24. 10.1037/h0021798, 14324558.
27. Wulff HR. Rational Diagnosis and Treatment 1981, Oxford: Blackwell.
28. Young MJ, Eisenberg JM, Williams SV, Hershey JC. Comparing aggregate estimates of derived thresholds for clinical decisions. Health Serv Res 1986, 20(6, Part I):763-80. 1068926, 3949540.
29. Berkey CS, Douglass CW, Valachovic RW, Chauncey HH, McNeil BJ. Statistical methods for comparing dental diagnostic procedures. Community Dent Oral Epidemiol 1990, 18:169-76. 10.1111/j.1600-0528.1990.tb00051.x, 2201479.
30. Douglass CW, McNeil BJ. Clinical decision analysis methods applied to diagnostic tests in dentistry. J Dent Educ 1983, 47(11):708-12.
31. Mileman PA, Vissers T, Purdell-Lewis DJ. The application of decision-making analysis to the diagnosis of approximal caries. Comm Dent Health 1986, 3:65-81.
32. Maryniuk GA. Clinical Decision-Making and Cost- Effectiveness: Impact on Treatment Choices. Quality Evaluation of Dental Restorations. Criteria for Placement and Replacement 1989, Hanover Park IL: Quintessence Publishing Co. Inc, Anusavice KJ.
33. Weinstein MC, Fineberg HV. Clinical Decision Analysis 1980, Philadelphia PA: W.B. Saunders.
34. Tulloch JFC, Antczak AA, Wilkes JW. The application of decision analysis to evaluate the need for extraction of asymptomatic third molars. J Oral Maxillofac Surg 1987, 45:855-63. 10.1016/0278-2391(87)90236-9, 3309225.
35. Feinstein AR. Clinical Judgment 1967, Huntington NY: Krieger.
36. Scadding JG. Diagnosis: the clinician and the computer. Lancet 1967, 290(7521):877-882.
37. Norman GR. Problem-solving skills, solving problems and problem-based learning. Med Educ 1988, 22:279-86. 10.1111/j.1365-2923.1988.tb00754.x, 3050382.
38. Gale J, Marsden P. Medical Diagnosis. From Student to Clinician 1983, Oxford: Oxford University Press.
39. Thyne JM. The Psychology of Learning and Techniques of Teaching 1966, London: University of London Press.
40. Page G, Bordage G, Allen T. Developing key-feature problems and examinations to assess clinical decision-making skills. Acad Med 1995, 70(3):194-201. 10.1097/00001888-199503000-00009, 7873006.
41. Gale J, Marsden P. Clinical problem solving; the beginning of the process. Med Educ 1982, 16:22-6. 10.1111/j.1365-2923.1982.tb01214.x, 7057720.
42. Grant J, Marsden P. The structure of memorised knowledge in students and clinicians: an explanation for diagnostic expertise. Med Educ 1987, 21:92-8. 10.1111/j.1365-2923.1987.tb00672.x, 3574171.
43. Criteria Manual, International Caries Detection and Assessment System (ICDAS): Baltimore, MD. 03/12-14/05. NIDCR, ADA, IADR. Consulted 10/23/08 in http://www.dundee.ac.uk/dhsru/docs/ICDAS%20II%20criteria%20document%20September%2010.doc.
44. Holsti OR. Content Analysis. Handbook of Social Psychology, Vol. 2, Research Methods 1968, Reading MA: Addison-Wesley, Lindzey G, Aronson E.
45. Weber RP. Basic Content Analysis. SAGE University Papers, Series: Quantitative Applications in the Social Sciences 1985, Newbury Park, CA: Sage Publications Inc.
46. Krippendorff K. Content Analysis. An Introduction to its Methodology. The SAGE CommText Series 1980, 5. Newbury Park, CA: Sage Publications Inc.
47. Holsti OR. Content Analysis for the Social Sciences and Humanities 1969, Reading MA: Addison-Wesley.
48. Neufeld VR, Norman GR, Feightner JW, Barrows HS. Clinical problem solving by medical students: a cross-sectional and longitudinal analysis. Med Educ 1981, 15:315-322. 10.1111/j.1365-2923.1981.tb02495.x, 6973686.
49. Bordage G, Zacks R. The structure of medical knowledge in the memories of medical students and general practitioners: categories and prototypes. Med Educ 1984, 18:406-416. 10.1111/j.1365-2923.1984.tb01295.x, 6503748.
50. Grant J, Marsden P. Primary knowledge, medical education and consultant expertise. Med Educ 1988, 22:173-179. 10.1111/j.1365-2923.1988.tb00002.x, 3405111.
51. Woods N, Howey EHA, Brooks LR, Norman GR. Speed kills? Speed, accuracy, encapsulations and causal understanding. Med Educ 2006, 40:973-979. 10.1111/j.1365-2929.2006.02556.x, 16987187.
52. Verkoeijen PPJL, Rikers RMJPm Schmidt HG, Van De Wiel MWJ, Kooman JP. Case representation by medical experts, intermediates and novices for laboratory data presented with or without a clinical context. Med Educ 2004, 38:617-627. 10.1046/j.1365-2923.2004.01797.x, 15189258.
53. Rikers RM, Loyens SM, Schmidt HG. The role of encapsulated knowledge in clinical case representations of medical students and family doctors. Med Educ 2004, 38:1035-1043. 10.1111/j.1365-2929.2004.01955.x, 15461648.
54. Rikers RM, Loyens SM, Winkel T, Schmidt HG, Sins PH. The role of biomedical knowledge in clinical case reasoning: A lexicon decision study. Academic Med 2005, 80:945-9.
55. Reyna VF, Lloyd FJ, Brainerd CJ. Memory, development, and rationality: An integrative theory of judgment and decision-making. Emerging Perspectives on Judgment and Decision Research 2003, New York: Cambridge University Press, Schneider S, Shanteau J.
56. Reyna VF, Lloyd FJ. Physician decision making and cardiac risk: Effects of knowledge, risk perception, risk tolerance, and fuzzy processing. J Exper Psych: Applied 2006, 12(3):179-95.
57. Gale J, Marsden P. The role of the routine clinical history. Med Educ 1984, 18:96-100. 10.1111/j.1365-2923.1984.tb00980.x, 6700454.
58. Chambers DW, Geissberger M. Toward a competency analysis of operative dentistry technique skills. J Dent Educ 1997, 61(10):795-803.
59. Norman GR, Eva KW. Doggie diagnosis, diagnostic success and diagnostic reasoning strategies: an alternative view. Med Educ 2003, 37:676-677. 10.1046/j.1365-2923.2003.01528.x, 12895245.
60. Eva KW. What every teacher needs to know about clinical reasoning. Med Educ 2004, 39:98-106.
61. Schmidt HG, Boshuizen HPA. On the origin of intermediate effects in clinical case recall. Mem Cognit 1993, 21:338-351.
62. Schmidt HG, Boshuizen HPA. On acquiring expertise in medicine. Educ Psychol Rev 1993, 5:205-221.
63. Maupomé G. A comparison of senior dental students and normative standards with regard to caries assessment and treatment decisions to restore occlusal surfaces of permanent teeth. J Prosth Dent 1998, 79(5):596-603.
64. Maupomé G. Cumulative assessment of factors leading to restorative decisions in an educational environment. A graphical demonstration using an in vitro case. Operative Dentistry 2000, 25(4):336-43.
65. Reyna VF, Brainerd CJ. Fuzzy-trace theory: An interim synthesis. Learn Individ Diff 1995, 7:1-75.