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1.
Mayo Clin Proc ; 91(12): 1761-1768, 2016 12.
Article in English | MEDLINE | ID: mdl-28029347

ABSTRACT

OBJECTIVE: To improve the clinical reasoning skills of postgraduate students in internal medicine through 2 kinds of extracurricular books: medical nonfiction and nonmedical fiction. METHODS: Clinical reasoning is difficult to define, understand, observe, teach, and measure. This is an educational innovation under an experimental framework based on a cognitive intervention grounded in constructivist and cognitivist theories. This study was conducted from June 1, 2014, through May 31, 2015. It was a pre-post, randomized, controlled, prospective, mixed-methods, small-group study. The intervention was through medical nonfiction and nonmedical fiction books. The process was structured to ensure that the students would read the material in phases and reflect on them. Clinical reasoning (pretests and posttests) was quantitatively assessed using the Diagnostic Thinking Inventory (DTI) and clinical reasoning exercises (CREs) and their assessment using a rubric. A qualitative design was used, and face-to-face semistructured interviews were conducted. RESULTS: Posttest total scores (DTI=188.92; CREs=53.92) were higher for the study group after the intervention compared with its own pretest scores (DTI=165.25; CREs=41.17) and with the pretest (DTI=159.27; CRE=40.73) and posttest (DTI=166.91; CREs=41.18) scores of the control group. Interviews with the study group confirmed that the intervention was acceptable and useful in daily practice. CONCLUSION: We introduced, evaluated, and proved an approach to teaching-learning clinical reasoning based on the assumption that the clinical reasoning skills of postgraduate students in internal medicine can be enhanced through 2 kinds of extracurricular books and that fun as well as interest will enhance learning. This study is not only about teaching-learning clinical reasoning but also about the humanities in medical education.


Subject(s)
Books , Clinical Competence , Clinical Decision-Making , Education, Medical, Graduate/methods , Internal Medicine/education , Students, Medical/psychology , Curriculum , Female , Humans , Male , Patient Simulation , Problem Solving
2.
J Pharmacol Pharmacother ; 3(1): 68-70, 2012 Jan.
Article in English | MEDLINE | ID: mdl-22368425

ABSTRACT

Bowel ischemia is a rare and potential life-threatening disorder. The reason for its rarity is the difficulty in its diagnosis. Vague and nonspecific clinical findings and limitations of diagnostic and treatment options make this disease a significant challenge. We hereby report two cases of non-occlusive mesenteric ischemia and the use of cilostazol in the successful management of such cases.

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