HELPING STUDENTS LEARN TO THINK LIKE EXPERTS WHEN SOLVING CLINICAL PROBLEMS

Analysis of problem solving strategies reveals that although there is no universal, generic problem-solving process, there is a clinical rea soning process that is specific and highly tailored to the complexity of each clinical problem. Research reveals that successful problem sol vers must possess comprehensive knowledge, but that the way they organ ize and understand their knowledge is even more critical. Moreover, us ing ''schemes'' for both learning and problem solving provides the adv antage of combining the creation of a knowledge structure and a search -and-retrieval strategy into a single operation. (A ''scheme'' in this context is a mental categorization of knowledge that includes a parti cular organized way of understanding and responding to a complex situa tion.) The implication for medical education is that a comprehensive k nowledge domain must be appropriately organized for knowledge mastery, which in turn is essential for clinical problem solving. Problem-solv ing strategies must be specific for each problem and not based on the assumption of a universal generic process. Consequently, a new taxonom y of medical problems is recommended, along with an altered problem-ba sed learning (PBL) format. The ''hypothetico-deductive'' strategy trad itionally used in PBL should be replaced by scheme-driven search strat egies so that students develop a more organized and logical approach t o problem solving.