부산대학교 도서관

Objective: Cognitive interventions using concept maps to enhance analytical thinking and decision making may improve evidence implementation. Method: The two generic maps that were tested are the BESD diagnosis (Bedside Clinical Diagnosis, Etiological Cause/Precipitant and Severity Score Diagnostic Labeling) and the 5S (Symptomatic, Supportive, Specific, Specialty Referral and Site of Care) concept maps. Trainees in residency training programs were presented with classic case scenarios. They were requested to outline in an answer sheet their diagnosis and their immediate therapeutic interventions. Once completed, the same case scenario was resubmitted to the trainee but this time, the answer sheet was restructured along the two concept maps. The two answer sheets were then compared with regards the explicit inclusion of the various domains of diagnosis and management as outlined in the two maps. Results: A total of 72 trainees were tested. These were grouped into R1 residents and Interns (Juniors, 29 candidates) and R2, R3 and R4 residents (Seniors, 43 candidates). Etiologic labeling improved by 82.8% in juniors and by 60.5% in seniors, and severity categorization by 79.3% and 88.4% respectively. Symptomatic care inputs increased by 69% in juniors and 67.1% in seniors, and documentation of sites of care by 86.2% and 76.7% respectively. An extra 75.9% of juniors and 58.1% of seniors included specialty referral as part of their immediate therapeutic interventions. Conclusions: The BESD and 5S generic concept maps improved trainees' diagnostic labeling and management decision-making process. Routine use of these maps in residents' training may result in better knowledge translation. [ABSTRACT FROM AUTHOR]