Two approaches to the study of diagnostic thinking are compared, one mainly propositional, namely that of Patel and Groen (1986), the other mainly semantic, that of Lemieux and Bordage (1986). Patel and Groen analyzed the linear dimension of cardiologists' discourses while solving a case of acute bacterial endocarditis, that is, the before and after propositional rules. A secondary analysis of two of their pothophysiological protocols is done using structural semantic techniques from Lemieux and Bordage where the vertical dimension of the (...) discourses is analyzed, that is, the levels of meaning or semantic axes. Contrary to Patel and Groen's position, making an accurate diagnosis is not explained in terms of pure forward reasoning through networks of causal rules, but by means of networks of semantic qualities abstracted from the symptoms and signs. The semantic qualities operate in the clinician's mind in terms of binary oppositions (e.g., sudden-gradual, unilateral-bilateral) whereby each pair of properties constitutes a semantic axis (e.g., sudden-gradual). The successful diagnosticians are those who use the most diversified and pertinent set of semantic axes and, therefore, have a deeper representation of the problem. (shrink)

Cognitive science is a multidisciplinary science concerned with understanding and utilizing models of cognition. It has spawned a great dealof research on applications such as expert systems and intelligent tutoring systems, and has interacted closely with psychological research. However, it is generally accepted that it is difficult to apply cognitive-scientific models to medical training and practice. This book is based on a NATO Advanced Research Workshop held in Italy in 1991, the purpose of which was to examine the impact ofmodels (...) of cognition on medical training and practice and to outline future research programmes relating cognition and education, and in particular to consider the potential impact of cognitive science on medical training and practice. A major discovery presented in the book is that the research areas related to artificial intelligence, cognitive psychology, and medical decision making are considerably closer, both conceptually and theoretically, than many of the workshop participants originally thought. (shrink)