Fostering diagnostic competence in prospective mathematics elementary teachers through epistemic activities.

Research on fostering teachers' diagnostic competence and thinking has become increasingly important. To this end, research has already identified several aspects of effective fostering of teachers' diagnostic competence. One of the aspects is assignment of the role as a teacher in interventions but, so far, assignment of the role of student has hardly been considered. Based on a model of the diagnostic thinking process, this paper operationalizes the role of the student by solving specific tasks and the role of the teacher by analyzing student solutions. Furthermore, based on previous research, it is assumed that assigning both roles is effective in promoting diagnostic competence. The following research addresses the development of 137 prospective teachers' diagnostic thinking in an experimental pre-post-test study with four treatment conditions, which vary prospective teachers' working with tasks and students' solutions to those tasks. The quantitative results show that a treatment integrating focus on tasks and students' solutions is equally as effective as a treatment focusing solely on students' solutions, and also that a treatment focusing solely on tasks has no effect.

Theories of truth and teaching clinical reasoning and problem solving.

In this paper, we will first discuss two current meta-theories dealing with different, aspects of "truth". The first metatheory conceives of truth in terms of coherence (rationality, consistency): a body of knowledge is true when it contains no inconsistencies and has at least some credibility. The second metatheory conceives of truth as correspondence, i.e., empirical accuracy. The two metatheories supplement each other, but are also incommensurable, i.e., they cannot be expressed in each other's terms, for they employ completely different criteria to establish truth (Englebretsen in Bare facts and naked truths: a new correspondence theory of truth, Routledge, London, 2005). We will discuss both the role of both metatheories in medicine, in particular in medical education in a clinical context. In line with Hammond's view (Med Decis Mak 16(3):281-287, 1996a; Human judgment and social policy: irreducible uncertainty, inevitable error, unavoidable injustice, Oxford University Press, New York, 1996b), we will extend the two metatheories to two forms of competence: coherence competence and correspondence competence, and demonstrate that distinguishing these two forms of competence increases our insights as to the best way to teach undergraduate students clinical problem solving.

How case representations of medical students change during case processing - Results of a qualitative study.

Objective: Representations are mental summaries of a clinical case and help in understanding a clinical problem. However, it is still largely unknown which clinical information medical students include in their case representations. In this study, therefore, the structure and quality of students' case representations were examined to better understand the diagnostic process and its relationship to diagnostic accuracy. What information do medical students include in their representations and is there an association between this information and the diagnostic accuracy? Method: 43 medical students in the fourth and fifth clinical year worked on four clinical cases. During the diagnostic process, they were asked three times per case to write a case representation. 516 representations were qualitatively evaluated using a content-based coding scheme. An analysis was made of the nature and composition of the clinical information. In addition, the association between the general representation structure and the correct case solution was examined. Results: At the beginning, students include most of the clinical information in their representation (66%), but as the case progresses, they begin to select the information offered (2nd representation 42%, 3rd representation 38%). The length of the representation (number of words) does not correlate with the correct case solution (r=-0.08-0.31). The representations do not depend on the case difficulty but have a significant individual component: the representations written by a student are formally very similar in all four cases (r=0.60-0.86). Conclusion: Medical students can select the relevant clinical information and include it in their case representations. Lack of representation does not seem to be a reason for misdiagnosis; Students' deficits in diagnosis are more likely due to knowledge gaps.

Proposal on ROC-theory based quantitative assessment of radiologists'diagnostic competence / 中华医院管理杂志

Perfofinance of the radio-diagnostic system can be evaluated quantitatively by the analysis method of the ROC curve.Areas under the ROC curves represent the diagnostic perfogrmance efficiency.A comparison of the perforrmance variance of the diagnostic system incurred by different diagnosticians,will find the diagnostic competence of individual diagnosticians.This can help hospital management in deploying personnel in the department of radiology reasonably.