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September 23 2009

Clinical Gist and Medical EducationConnecting the Dots

Author Affiliations

Author Affiliations: Division of General Internal Medicine, Department of Medicine and Mayo Clinic Education Technology Center, Mayo Clinic College of Medicine, Rochester, Minnesota (Dr Lloyd); and Center for Behavior Economics and Decision Research, Cornell University, Ithaca, New York (Dr Reyna).

JAMA. 2009;302(12):1332-1333. doi:10.1001/jama.2009.1383

There is little evidence that continuing medical education improves practicing physicians' clinical reasoning and the quality of care.1 The central roles of medical education include helping clinicians assimilate new knowledge and assessing clinicians' performance. Although electronic sources can deliver information quickly, human cognitive processes do not allow clinicians to encode all the information into memory promptly and predictably at the point of care (including approximately 1500 articles indexed daily by the National Library of Medicine).2 When learning new information, humans rely on 2 types of memory: verbatim and gist.2,3Verbatim representations capture the literal facts or “surface form” of information (eg, that a cardiac syndrome is called Takotsubo cardiomyopathy), whereas gist representations capture its meaning or interpretation (eg, that the syndrome may be elicited by stress in the absence of coronary artery disease).

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