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Showing Your Thinking: Using Mind Maps to Understand the Gaps Between Experienced Emergency Physicians and Their Students.

ABSTRACT: Background:Clinical teaching faculty rely on schemas for diagnosis. When they attempt to teach medical students, there may be a gap in the interpretation because the students do not have the same schemas. The aim of this analysis was to explore expert thinking processes through mind maps, to help determine the gaps between an expert's mind map of their diagnostic thinking and how students interpret this teaching artifact. Methods:A novel mind-mapping approach was used to examine how emergency physicians (EPs) explain their clinical reasoning schemas. Nine EPs were shown two different videos of a student interviewing a patient with possible venous thromboembolism. EPs were then asked to explain their diagnostic approach using a mind map, as if they were thinking to a student. Later, another medical student interviewed the EPs to clarify the mind map and revise as needed. A coding framework was generated to determine the discrepancy between the EP-generated mind map and the novice's interpretation. Results:Every mind map (18 mind maps from nine individuals) contained some discrepancy between the expert's mind and novice's interpretation. From the qualitative analysis of the changes between the originally created mind map and the later revision, the authors developed a conceptual framework describing types of amendments that students might expect teachers to make in their mind maps: 1) substantive amendments, such as incomplete mapping; and 2) clarifications, such as the need to explain background for a mind map element. Conclusion:Emergency physician teachers tend to make jumps in reasoning, most commonly including incomplete mapping and maps requiring clarifications. Educating EPs on these processes will allow modification of their teaching modalities to better suit learners.

SUBMITTER: Gossack-Keenan K

PROVIDER: S-EPMC6965674 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Showing Your Thinking: Using Mind Maps to Understand the Gaps Between Experienced Emergency Physicians and Their Students.

Gossack-Keenan Kira K De Wit Kerstin K Gardiner Emily E Turcotte Michelle M Chan Teresa M TM

AEM education and training 20190901 1

<h4>Background</h4>Clinical teaching faculty rely on schemas for diagnosis. When they attempt to teach medical students, there may be a gap in the interpretation because the students do not have the same schemas. The aim of this analysis was to explore expert thinking processes through mind maps, to help determine the gaps between an expert's mind map of their diagnostic thinking and how students interpret this teaching artifact.<h4>Methods</h4>A novel mind-mapping approach was used to examine h ...[more]

PMID: 31989071

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Project description:BackgroundDecision-making relies on both analytical and emotional thinking. Cognitive reasoning styles (e.g. maximizing and satisficing tendencies) heavily influence analytical processes, while affective processes are often dependent on regret. The relationship between regret and cognitive reasoning styles has not been well studied in physicians, and is the focus of this paper.MethodsA regret questionnaire and 6 scales measuring individual differences in cognitive styles (maximizing-satisficing tendencies; analytical vs. intuitive reasoning; need for cognition; intolerance toward ambiguity; objectivism; and cognitive reflection) were administered through a web-based survey to physicians of the University of South Florida. Bonferroni's adjustment was applied to the overall correlation analysis. The correlation analysis was also performed without Bonferroni's correction, given the strong theoretical rationale indicating the need for a separate hypothesis. We also conducted a multivariate regression analysis to identify the unique influence of predictors on regret.Results165 trainees and 56 attending physicians (age range 25 to 69) participated in the survey. After bivariate analysis we found that maximizing tendency positively correlated with regret with respect to both decision difficulty (r=0.673; p<0.001) and alternate search strategy (r=0.239; p=0.002). When Bonferroni's correction was not applied, we also found a negative relationship between satisficing tendency and regret (r=-0.156; p=0.021). In trainees, but not faculty, regret negatively correlated with rational-analytical thinking (r=-0.422; p<0.001), need for cognition (r=-0.340; p<0.001), and objectivism (r=-0.309; p=0.003) and positively correlated with ambiguity intolerance (r=0.285; p=0.012). However, after conducting a multivariate regression analysis, we found that regret was positively associated with maximizing only with respect to decision difficulty (r=0.791; p<0.001), while it was negatively associated with satisficing (r=-0.257; p=0.020) and objectivism (r=-0.267; p=0.034). We found no statistically significant relationship between regret and overall accuracy on conditional inferential tasks.ConclusionRegret in physicians is strongly associated with their tendency to maximize; i.e. the tendency to consider more choices among abundant options leads to more regret. However, physicians who exhibit satisficing tendency - the inclination to accept a "good enough" solution - feel less regret. Our observation that objectivism is a negative predictor of regret indicates that the tendency to seek and use empirical data in decision-making leads to less regret. Therefore, promotion of evidence-based reasoning may lead to lower regret.

Project description:The need to establish a research field within psychology didactics at secondary level has recently been voiced by several researchers internationally. An analysis of a Swedish case coming out of secondary level education in psychology presented here provides an illustration that complexity thinking-derived from complexity theory-is uniquely placed to consider and indicate possible solutions to challenges, described by researchers as central to the foundation of a new field. Subject matter didactics is defined for the purpose of this paper as a combination of general didactics and subject matter content, and considering the international nature of research traditions coming out of psychology, the implications of the results presented here cannot be regarded as limited solely to national concerns. An online survey was sent to secondary schools in Sweden. Discussions and lectures along with teaching to the book-alternatively used as inspiration-emerged as central from the thematic analysis of the results, providing the first mapping of teaching practices secondary level psychology in Sweden. An analysis, founded on complexity thinking-combined with a model enabling a delimitation of the scope of study-focused on time use and the importance placed on self-knowledge, along with the transformation of theory into practice. The former pointed to a teacher-centered nested subsystem (e.g., asymmetric relations between teachers and students), whereas the latter pointed to student-centered nested subsystems coming out of embodied knowledge (e.g., students as node) where psychological perspectives are learnt through self-reflection, case studies, and everyday life experiences (turning theory to practice), implying a holistic approach. The analysis applied to the Swedish case provides an illustration of how complexity theory has the potential to address challenges at the micro and the macro levels to the establishment of a new research field in psychology didactics and to indicate possible solutions (drawing among other things upon teaching experiences coming out of the Swedish case study). Psychology's high relevance to everyday life, multi-causality, perspective pluralism, dynamic systems character, and scientific character make complexity thinking a relevant approach in the consideration of challenges to the establishment of a research field in didactics of psychology.

Project description:BACKGROUND:The current versions of reference genome assemblies still contain gaps represented by stretches of Ns. Since high throughput sequencing reads cannot be mapped to those gap regions, the regions are depleted of experimental data. Moreover, several technology platforms assay a targeted portion of the genomic sequence, meaning that regions from the unassayed portion of the genomic sequence cannot be detected in those experiments. We here refer to all such regions as inaccessible regions, and hypothesize that ignoring these regions in the null model may increase false findings in statistical testing of colocalization of genomic features. RESULTS:Our explorative analyses confirm that the genomic regions in public genomic tracks intersect very little with assembly gaps of human reference genomes (hg19 and hg38). The little intersection was observed only at the beginning and end portions of the gap regions. Further, we simulated a set of synthetic tracks by matching the properties of real genomic tracks in a way that nullified any true association between them. This allowed us to test our hypothesis that not avoiding inaccessible regions (as represented by assembly gaps) in the null model would result in spurious inflation of statistical significance. We contrasted the distributions of test statistics and p-values of Monte Carlo-based permutation tests that either avoided or did not avoid assembly gaps in the null model when testing colocalization between a pair of tracks. We observed that the statistical tests that did not account for assembly gaps in the null model resulted in a distribution of the test statistic that is shifted to the right and a distribution of p-values that is shifted to the left (indicating inflated significance). We observed a similar level of inflated significance in hg19 and hg38, despite assembly gaps covering a smaller proportion of the latter reference genome. CONCLUSION:We provide empirical evidence demonstrating that inaccessible regions, even when covering only a few percentages of the genome, can lead to a substantial amount of false findings if not accounted for in statistical colocalization analysis.

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Showing Your Thinking: Using Mind Maps to Understand the Gaps Between Experienced Emergency Physicians and Their Students.

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Showing Your Thinking: Using Mind Maps to Understand the Gaps Between Experienced Emergency Physicians and Their Students.

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