An investigation of the diagnostic problem solving methods used by resident neurologists

Abstract

Six resident neurologists from the Los Angeles Country Hospital were asked to diagnose the same neurological problem. The problem was presented by an actress who simulated the symptoms and signs of multiple sclerosis. This provided each resident with the same opportunity to obtain information about the problem. The resident was asked to perform an evaluation of the patient employing the methods that he would normally use with an actual patient. The interview and physical examination performed by the resident was videotaped. After making his diagnosis, the resident was interviewed about the methods he used with the patient. This data was categorized in accordance with areas previously observed to be an essential part of any neurological diagnostic situation. By using these categories and the relationship among them, it was possible to describe some of the residents' problem solving methods.