Academic medicine : journal of the Association of American Medical Colleges
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Current focus in medical education on competencies and curricular objectives draws attention to boundaries rather than the openness inherent in the learning process. This qualitative study explored the tension between boundedness (mandated curricular objectives) and openness (variability in learning experience as students traverse the explicit, implicit, and extracurriculum) in the curriculum. ⋯ The findings can inform discussions about how to balance the boundedness of curricular mandates with the inherent openness of students' learning experiences.
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Recently, human reasoning, problem solving, and decision making have been viewed as products of two separate systems: "System 1," the unconscious, intuitive, or nonanalytic system, and "System 2," the conscious, analytic, or reflective system. This view has penetrated the medical education literature, yet the idea of two independent dichotomous cognitive systems is not entirely without problems. This article outlines the difficulties of this "two-system view" and presents an alternative, developed by K. ⋯ First, human reasoning, problem solving, and decision making can be arranged on a cognitive continuum, with pure intuition at one end, pure analysis at the other, and a large middle ground called "quasirationality." Second, the nature and requirements of the cognitive task, as perceived by the person performing the task, determine to a large extent whether a task will be approached more intuitively or more analytically. Third, for optimal task performance, this approach needs to match the cognitive properties and requirements of the task. Finally, the author makes a case that CCT is better able than a two-system view to describe medical problem solving and clinical reasoning and that it provides clear clues for how to organize training in clinical reasoning.
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To study the prevalence of potentially illegal questions in residency interviews and to identify the impact of such questions on applicants' decisions to rank programs. ⋯ Many residency applicants were asked potentially illegal questions. Developing a formal interview code of conduct targeting both applicants and programs may be necessary to address the potential flaws in the resident selection process.