Clinical reasoning in pharmacy: What do eye movements and verbal protocols tell us about the processing of a case task?

This study investigates pharmacy students' reasoning while solving a case task concerning an acute patient counselling situation in a pharmacy. Participants' (N = 34) reasoning processes were investigated with written tasks utilizing eye-tracking in combination with verbal protocols. The case was presented in three pages, each page being followed by written questions. Eye movements were recorded during case processing. Success in the task required differentiating the relevant information from the task redundant information, and initial activation of several scripts and verification of the most likely one, when additional information became available. 2nd (n = 16) and 3rd (n = 18)-year students' and better and worse succeeding students' processes were compared. The results showed that only a few 2nd-year students solved the case correctly, whereas almost all of the 3rd-year students were successful. Generally, the average total processing times of the case material did not differ between the groups. However, better-succeeding and 3rd-year students processed the very first task-relevant sentences longer, indicating that they were able to focus on relevant information. Differences in the written answers to the 2nd and 3rd question were significant, whereas differences regarding the first question were not. Thus, eye-tracking seems to be able to capture illness script activation during case processing, but other methods are needed to depict the script verification process. Based on the results, pedagogical suggestions for advancing pharmacy education are discussed.

Lexicons of Key Terms in Scholarly Texts and Their Disciplinary Differences: From Quantum Semantics Construction to Relative-Entropy-Based Comparisons.

Complex networks are often used to analyze written text and reports by rendering texts in the form of a semantic network, forming a lexicon of words or key terms. Many existing methods to construct lexicons are based on counting word co-occurrences, having the advantage of simplicity and ease of applicability. Here, we use a quantum semantics approach to generalize such methods, allowing us to model the entanglement of terms and words. We show how quantum semantics can be applied to reveal disciplinary differences in the use of key terms by analyzing 12 scholarly texts that represent the different positions of various disciplinary schools (of conceptual change research) on the same topic (conceptual change). In addition, attention is paid to how closely the lexicons corresponding to different positions can be brought into agreement by suitable tuning of the entanglement factors. In comparing the lexicons, we invoke complex network-based analysis based on exponential matrix transformation and use information theoretic relative entropy (Jensen-Shannon divergence) as the operationalization of differences between lexicons. The results suggest that quantum semantics is a viable way to model the disciplinary differences of lexicons and how they can be tuned for a better agreement.

Exploring eye movements of experienced and novice readers of medical texts concerning the cardiovascular system in making a diagnosis.

This study used the eye-tracking method to explore how the level of expertise influences reading, and solving, two written patient cases on cardiac failure and pulmonary embolus. Eye-tracking is a fairly commonly used method in medical education research, but it has been primarily applied to studies analyzing the processing of visualizations, such as medical images or patient video cases. Third-year medical students (n = 39) and residents (n = 13) read two patient case texts in an eye-tracking laboratory. The analysis focused on the diagnosis made, the total visit duration per text slide, and eye-movement indicators regarding task-relevant and task-redundant areas of the patient case text. The results showed that almost all participants (48/52) made the correct diagnosis of the first patient case, whereas all the residents, but only 17 students, correctly diagnosed the second case. The residents were efficient patient-case-solvers: they reached the correct diagnoses, and processed the cases faster and with a lower number of fixations than did the students. Further, the students and residents demonstrated different reading patterns with regard to which slides they proportionally paid most attention. The observed differences could be utilized in medical education to model expert reasoning and to teach the manner in which a good medical text is constructed. Eye-tracking methodology appears to have a great deal of potential in evaluating performance and growing diagnostic expertise in reading medical texts. However, further research using medical texts as stimuli is required. Anat Sci Educ 10: 23-33. © 2016 American Association of Anatomists.