Research in Medical Problem Solving: A Review

This article is a review of problem-solving models that have been studied in the medical domain. These models seek to describe and evaluate the cognitive processes activated in problem solving in the medical domain and to use this knowledge to further evaluate expert–novice differences. The principle models discussed are the hypothetico–deductive, illness scripts, and the probabilistic. After reviewing these problem-solving models, the reasoning strategies identified in medical problem solving will be discussed. These strategies, forward–backward and broad-narrow, are analyzed as indicators of expert versus novice problem solving in the medical domain. Finally, the methods identified for studying medical problem solving—simulated patients, stimulated recall, think-aloud protocol, and the Pathfinder algorithm—will be discussed.