Knowledge Based Solution Strategies in Medical Reasoning

The techniques of propositionol analysis are used to examine the protocols of seven cardiologists in a task involving the diagnosis of a case of acute bacterial endocarditis and an explanation of its underlying pathophysiology. It is shown that the explanations of physicians making an accurate diagnosis can be accounted for in terms of a model consisting of pure forward reasoning through a network of causal rules, actuated by relevant propositions embedded in the stimulus text. These rules appear to derive from the physician's underlying knowledge base rather than any information in the text itself. In contrast, subjects with inacurate diagnoses tend to make use of a mixture of forward and backward reasoning, beginning with a high level hypothesis and proceeding in a top-down fashion to the propositions embedded in stimulus text, or to the generation of irrelevant rules.     

医学生医学伦理推理能力调查研究

采用中间概念测量法,围绕病人自主权、保密、有利、公平分配四个中间概念,对我国S省某医学院1108名医学生医学伦理推理行为表现和动机水平进行调查。调查发现,医学生在面对多重叠加的复杂伦理问题时,推理能力相对较差;对医学伦理行为动机的判定优于对行为的判定;医学生的年级、性别、医学伦理负面事件的干扰等因素,都会对其医学伦理推理能力产生影响。基于此,医学伦理教育应构建全方位、全环境的教育模式,明确教学目标、创新教育方式以加强伦理推理能力培养,充分利用隐性课程的积极作用。

     

专家医生的知识结构及诊断推理方式

医学专长研究中“中间者效应”的发现,引发了研究者对专家医生知识结构的探讨。在“知识打包”的基础上,医生的临床知识以“疾病脚本”的方式组织起来。随着临床经验的增加,专家医生积累了丰富的疾病脚本。在临床诊断中,他们无需对病人所有的体征和症状进行仔细地和系统地分析,而是通过非分析性的推理方式——“模式识别”或“样例识别”便可自动激活与之匹配的疾病脚本,据此对病人做出迅速而准确的诊断。医学专长的本质就在于专家医生以“疾病脚本”的方式组织起来的知识结构。“适应性专长”代表了未来医学专长研究的新方向     

Persisting Effects of Instruction on Young Children's Syllogistic Reasoning with Incongruent and Abstract Premises

Studies of reasoning have often invoked a distinction between a natural or ordinary consideration of the premises, in which they are interpreted, and even distorted, in the light of empirical knowledge, and an analytic or logical consideration of the premises, in which they are analysed in a literal fashion for their logical implications. Two or three years of schooling have been seen as critical for the spontaneous use of analytic reasoning. In two experiments, however, 4-year-olds who were given brief instructions that prompted use of an analytic approach continued to adopt this approach one week later. Thus, when given syllogistic problems in which the major premise was incongruent with their empirical knowledge (e.g. “All snow is black”), instructed children reasoned more accurately from that premise both immediately and a week later as compared to children given only a basic introduction. A third experiment showed that instructions also improved 4-year-olds' performance on hard-to-imagine, abstract material (e.g. “All mib is white”). Similarities between the effects of brief instruction and of schooling are discussed.     

因果信息和提示指导语对大学生贝叶斯推理的影响

基于三重加工心智模型，以大学生为被试，采用经典贝叶斯推理的文本范式，通过操纵自变量：因果信息（有或无）与提示指导语（提供或不提供），试图探讨激发反省心智，消解理性障碍的情况下，因果贝叶斯框架的作用机制。估计正确率和准确性的结果都表明因果信息显著提高了贝叶斯推理成绩，准确性的结果也说明指导语可以提示被试放下既有观念，以无偏见的方式进行推理，从而有效促进了贝叶斯推理表现。而在提示条件下增加因果信息并没有促进作用，表明对于较高元认知的被试因果信息作用是有限的。     

因果信息和提示指导语对大学生贝叶斯推理的影响

基于三重加工心智模型,以大学生为被试,采用经典贝叶斯推理的文本范式,通过操纵自变量：因果信息（有或无）与提示指导语（提供或不提供）,试图探讨激发反省心智,消解理性障碍的情况下,因果贝叶斯框架的作用机制。估计正确率和准确性的结果都表明因果信息显著提高了贝叶斯推理成绩,准确性的结果也说明指导语可以提示被试放下既有观念,以无偏见的方式进行推理,从而有效促进了贝叶斯推理表现。而在提示条件下增加因果信息并没有促进作用,表明对于较高元认知的被试因果信息作用是有限的。     

A Slippery Myth: How Learning Style Beliefs Shape Reasoning about Multimodal Instruction and Related Scientific Evidence

The learning style myth is a commonly held myth that matching instruction to a student's “learning style” will result in improved learning, while providing mismatched instruction will result in suboptimal learning. The present study used a short online reasoning exercise about the efficacy of multimodal instruction to investigate the nature of learning styles beliefs. We aimed to: understand how learning style beliefs interact with beliefs about multimodal learning; characterize the potential complexity of learning style beliefs and understand how this short exercise might influence endorsements of learning styles. Many participants who believed in the learning style myth supported the efficacy of multimodal learning, and many were willing to revise their belief in the myth after the exercise. Personal experiences and worldviews were commonly cited as reasons for maintaining beliefs in learning styles. Findings reveal the complexity of learning style beliefs, and how they interact with evidence in previously undocumented ways.     

医学人文素质教育与小班化教学

中国医学人文教育正处于起步、探索阶段,课堂教学是主要渠道和途径,而目前各校的医学人文教育采取的大班课教学方式影响了教学效果。从医学人文教育的理念和教育规律出发,并借鉴他国的经验,小班化教学应是落实人文教育的实效性一个中心环节。     

The Reasoning View and Defeasible Practical Reasoning

According to the Reasoning View about normative reasons, facts about normative reasons for action can be understood in terms of facts about the norms of practical reasoning. I argue that this view is subject to an overlooked class of counterexamples, familiar from debates about Subjectivist theories of normative reasons. Strikingly, the standard strategy Subjectivists have used to respond to this problem cannot be adapted to the Reasoning View. I think there is a solution to this problem, however. I argue that the norms of practical reasoning, like the norms of theoretical reasoning, are characteristically defeasible, in a sense I make precise. Recognizing this property of those norms makes space for a solution to the problem. The resulting view is in a way analogous to the familiar defeasibility theory of knowledge, but it avoids a standard objection to that theory.     

Reasoning and rationalization

Contra Lewis, it is argued that the correspondence theory is a genuine rival theory of truth: it goes beyond the redundancy theory; it competes with other theories of truth; it is aptly summarized by the slogan 'truth is correspondence to fact'; and it really is a theory of truth.     

Reasoning and Explaining

When regimented in a certain natural way, the concepts of explanation and justification manifest a pattern of interrelations connected more or less systematically to their object. Besides its intrinsic interest, this pattern may give us some insight into the nature, source, and limits of the concept of argument.     

Reasoning and Representing

I argue that logical understanding is not propositional knowledgebut is rather a species of practical knowledge. I further arguethat given the best explanation of logical understanding someversion or another of inferential role semantics must be the correct account of the determinants of logical content.     

Reasoning and logic

Gilbert Harman, in Logic and Reasoning (Synthese 60 (1984), 107–127) describes an unsuccessful attempt ... to develop a theory which would give logic a special role in reasoning. Here reasoning is psychological, a procedure for revising one's beliefs. In the present paper, I construe reasoning sociologically, as a process of linguistic interaction; and show how both reasoning in the psychologistic sense and logic are related to that process.     

Propositional Reasoning that Tracks Probabilistic Reasoning

This paper concerns the extent to which uncertain propositional reasoning can track probabilistic reasoning, and addresses kinematic problems that extend the familiar Lottery paradox. An acceptance rule assigns to each Bayesian credal state p a propositional belief revision method ${\sf B}_{p}$ , which specifies an initial belief state ${\sf B}_{p}(\top)$ that is revised to the new propositional belief state ${\sf B}(E)$ upon receipt of information E. An acceptance rule tracks Bayesian conditioning when ${\sf B}_{p}(E) = {\sf B}_{p|_{E}}(\top)$ , for every E such that p(E)?>?0; namely, when acceptance by propositional belief revision equals Bayesian conditioning followed by acceptance. Standard proposals for uncertain acceptance and belief revision do not track Bayesian conditioning. The ??Lockean?? rule that accepts propositions above a probability threshold is subject to the familiar lottery paradox (Kyburg 1961), and we show that it is also subject to new and more stubborn paradoxes when the tracking property is taken into account. Moreover, we show that the familiar AGM approach to belief revision (Harper, Synthese 30(1?C2):221?C262, 1975; Alchourrón et al., J Symb Log 50:510?C530, 1985) cannot be realized in a sensible way by any uncertain acceptance rule that tracks Bayesian conditioning. Finally, we present a plausible, alternative approach that tracks Bayesian conditioning and avoids all of the paradoxes. It combines an odds-based acceptance rule proposed originally by Levi (1996) with a non-AGM belief revision method proposed originally by Shoham (1987).     

Coherence and Nonmonotonicity in Human Reasoning

Nonmonotonic reasoning is often claimed to mimic human common sense reasoning. Only a few studies, though, have investigated this claim empirically. We report four experiments which investigate three rules of SYSTEMP, namely the AND, the LEFT LOGICAL EQUIVALENCE, and the OR rule. The actual inferences of the subjects are compared with the coherent normative upper and lower probability bounds derived from a non-infinitesimal probability semantics of SYSTEM P. We found a relatively good agreement of human reasoning and principles of nonmonotonic reasoning. Contrary to the results reported in the ‘heuristics and biases’ tradition, the subjects committed relatively few upper bound violations (conjunction fallacies).