An evaluation of the clinical problem-solving process using a simulation technique.

Currently, research does not agree as to the extent to which medical content and problem-solving processes underlie clinical problem-solving. The results of research in this area fall into two categories: (1) clinical problem-solving is primarily dependent upon medical content specific within the case, and (2) clinical problem-solving is a skill, or series of skills, which can be applied to all clinical problems. In the study reported in this paper, seventy-one second-year medical students who had completed a 2-year, body-systems oriented curriculum were given an examination designed to measure clinical problem-solving. The results indicated that gathering data on patient history and hypotheses generation were specific skills common to clinical problem-solving, while hypotheses refinement, identification of relevant physical examinations, ordering laboratory investigations and making a diagnosis were case-related.