diagnostic problem solving, cognitive load theory, and cognitive tools – ten years of using the diagnostic pathfinder to teach clinical pathology
Jared Danielson*, Holly Bender,
PURPOSE: Medical educators have long studied
diagnostic problem solving in hopes of helping learners become better problem
solvers. The Diagnostic Pathfinder is a software tool that has been used for ten
years to teach this skill. This abstract reviews lessons learned from
Pathfinder-based research, and ties them to current theory.
METHODS: Several
studies exploring the Pathfinder’s effect on problem solving performance and
student/faculty satisfaction were reviewed, as well as studies and theoretical
writing involving medical diagnostic problem solving, cognitive load theory,
and cognitive tools. Pathfinder characteristics are explained in light of this
review.
RESULTS: The Diagnostic Pathfinder’s approach
seems most likely to be effective against diagnostic errors caused by data
integration problems. Studies suggest that Pathfinder use improves students’
performance on case-based problems by providing real life cases, creating a
safe practice environment, providing immediate and specific feedback, enforcing
sequence and completeness, and facilitating problem manipulation. The
Pathfinder can be seen as a cognitive tool, and as a tool that reduces
cognitive load. Cognitive tools provide processes that
the mind leverages to accomplish cognitive tasks, and, over time, can be
adopted by the mind as its own. Cognitive load theory suggests that effective
instruction respects intrinsic cognitive load, encourages germane cognitive
load, and avoids extraneous cognitive load.
CONCLUSION/FUTURE DIRECTIONS: The Pathfinder’s gating and feedback features appear to support germane cognitive load while reducing extraneous cognitive load. The Pathfinder also appears to function as a cognitive tool, leveraging processes that are used by the mind even after the tool is withdrawn.