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The deep play of medicine: Discursive and collaborative processing of evidence in medical problem solving PER MÅSEIDE Abstract Ethnographic research was conducted in the thoracic ward of a Norwegian university hospital in order to study collaborative medical problem solving. As a gen- eral principle, evidence-based medicine is supposed to lead the process of medical problem solving. However, medical problem solving also requires evidence of a dif- ferent kind. This is the more concrete form of evidence, such as X rays and other representations, that guides

An Analysis of Clinical Reasoning

Discourses of collaborative medical work PER MÅSEIDE Abstract This article looks at the hospital as an expert system organized to promote distributed processes of collaborative medical problem solving. It is com- posed by subsystems and the collaborative processes resemble processes of socially distributed cognition. Terms like ‘medical discourse’ or ‘institu- tional interaction’ have been used to describe verbal activities in collabo- rative medical practice. But the definitions of these terms give a limited understanding of collaborative medicine. Observations


Medical Problem Solving Medical Problem Solving An Analysis of Clinical Reasoning Arthur S. Elstein Lee S. Shulman Sarah A. Sprafka with Linda Allal Michael Gordon Hilliard Jason Norman Kagan Michael J. Loupe Ronald D. Jordan Harvard University Press Cambridge, Massachusetts and London, England 1978 Copyright © 1978 by the President and Fellows of Harvard Col lege All rights reserved Printed in the United States of America Library of Congress Cataloging in Publication Data Elstein, Arthur Shirle, 1935- Medical problem solving


References Index 305 311 323 Medical Problem Solving

0165–4888/03/0023–0369 © Walter de Gruyter Text 23(3) (2003), pp. 369–403 Medical talk and moral order: Social interaction and collaborative clinical work PER MÅSEIDE Abstract Medical problem solving is to a large extent accomplished through inter- professional collaboration. It may be imagined as a socially distributed cognitive process. Discourse provides access to this process while it also is the major tool for accomplishing collaborative work. The major topic of the article is the role played by moral discourses in collaborative medical reasoning and

. Representations of people with HIV and hepatitis C in editorials of medical journals: Discourses and interdiscursive relations 3 (1): 15–25. Leudar, Ivan, Charles Antaki, and Rebecca Barnes. When psychotherapists disclose personal information about themselves to clients 3 (1): 27–41. Måseide, Per. The deep play of medicine: Discursive and collaborative processing of evidence in medical problem solving 3 (1): 43–54. Michelle, Carolyn. Media(ted) fabrications: How the science–media symbiosis helped ‘sell’ cord banking 3 (1): 55–68. Nguyen, Hanh Thi. Constructing ‘expertness’: A

diagnostic uncertainty with patients, and advocate for teaching trainees how to have such conversations with patients. Clinical reasoning in the face of uncertainty In the field of cognitive science, patient illnesses are “ill-structured problems” [ 11 ], leading to unique challenges in clinical reasoning. For instance, medical problem-solving is often described as a series of conditional probabilities, where pre-test probabilities are modified by Bayes’ theorem, based on test characteristics, to yield post-test probabilities [ 12 ]. This mathematical framework is useful

of interest. References 1. Elstein AS, Shulman LS, Sprafka SA. Medical problem solving: an analysis of clinical reasoning. Cambridge, MA: Harvard University Press, 1978. 2. Kassirer JP, Gorry GA. Clinical problem solving: a behavioral analysis. Ann Intern Med 1978;89:245–55. 3. Broder J, Warshauer DM. Increasing utilization of computed tomography in the adult emergency department, 2000–2005. Emerg Radiol 2006;13:25–30. 4. Charboneau JW, Reading CC, Welch TJ. CT and sonographically guided needle biopsy: current techniques and new innovations. Am J Radiol 1990