Paradigms and problem-solving: a literature review.

Thomas Kuhn's conceptions of the influence of paradigms on the progress of science from the framework for analyzing how medical educators have approached research on medical problem-solving. Kuhn's ideas help to explain the often conflicting research results that have appeared over the last 20 years. Specifically, underlying assumptions about the problem-solving process are explored in light of data that demonstrate (a) low correlations between different measures of problem-solving, (b) inconsistent relationships between the amount of clinical experience and problem-solving ability, and (c) case specificity of performance. A new paradigm emphasizing multiple types of problems with varied solution strategies is proposed.