Stevens R H, Lopo A C, Wang P
Department of Microbiology and Immunology, UCLA School of Medicine 90024-1747, USA.
J Am Med Inform Assoc. 1996 Mar-Apr;3(2):131-8. doi: 10.1136/jamia.1996.96236281.
To determine whether expert problem-solving strategies can be identified within a large number of student performances of complex medical diagnostic simulations.
Self-organizing artificial neural networks were trained to categorize the performances of infectious disease subspecialists on six computer-based clinical diagnostic simulation that used the sequence of diagnostic tests requested as the input data. Six hundred seventy-six student solutions to these problems were presented to these trained neural networks to determine which, if any, of the student solutions represented those of the experts.
For each simulation, the expert performances clustered around one dominant output neurode, indicating that there were common problem-specific features associated with the experts' problem-solving performances. When the performances of students who also made correct problem diagnoses were tested on these expert-trained neural networks, 17% were classified as representing expert strategies, indicating that expert performance was a somewhat rare and inconsistent occurrence among the students.
The ability to identify a small number of expert-like strategies within a large body of student performances may provide an opportunity to study the dynamics of complex learning at both individual and population levels as well as the emergence of medical diagnostic expertise.
确定在大量学生进行复杂医学诊断模拟的表现中是否能识别出专家级的问题解决策略。
训练自组织人工神经网络,以便根据作为输入数据的所请求诊断测试序列,对传染病亚专科医生在六个基于计算机的临床诊断模拟中的表现进行分类。将针对这些问题的676个学生解决方案呈现给这些经过训练的神经网络,以确定哪些学生解决方案(如果有的话)代表了专家的解决方案。
对于每个模拟,专家的表现聚集在一个主要输出神经元周围,这表明与专家的问题解决表现相关存在特定于问题的共同特征。当在这些经过专家训练的神经网络上测试那些也做出正确问题诊断的学生的表现时,17%的表现被归类为代表专家策略,这表明专家级表现在学生中是一种相对罕见且不一致的情况。
在大量学生表现中识别出少量类似专家的策略,这一能力可能为在个体和群体层面研究复杂学习的动态过程以及医学诊断专业知识的形成提供机会。