Thirty years of illness scripts: Theoretical origins and practical applications
Medical TeacherPublished 2 September 2014
Eugène J. F. M. Custers
Citations175
SJR quartileQ1
SJR score1.25
SNIP2.36
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TL;DR
The illness script concept has solid underpinnings and can be used to elucidate aspects of medical expertise development and has yielded a specific test, the Script Concordance Test.
Abstract
The illness script concept has solid underpinnings and can be used to elucidate aspects of medical expertise development. It can also be used to formulate recommendations for clinical teaching and has yielded a specific test, the Script Concordance Test.
Keywords
Medicine
Language<b>Scripts, plans, goals, and understanding</b> : an inquiry into human knowledge structures. By Roger C. Schank and Robert P. Abelson. Hillsdale, NJ: Lawrence Erlbaum Associates, 1977. Pp. 248.
3,083 Citations1978David B. Kronenfeld
For both people and machines, each in their own way, there is a serious problem in common of making sense out of what they hear, see, or are told about the world.
The American Journal of PsychologyScripts, Plans, Goals, and Understanding: An Inquiry into Human Knowledge Structures
2,979 Citations1979Earl Hunt, Roger C. Schank +1 more
Cognitive PsychologyScripts in memory for text
1,585 Citations1979Gordon H. Bower, John B. Black +1 more
Academic MedicineA cognitive perspective on medical expertise
1,117 Citations1990Henk G. Schmidt, Gina Norman +1 more
A new theory of the development of expertise in medicine is outlined, which assumes that expertise is not so much a matter of superior reasoning skills or in-depth knowledge of pathophysiological states as it is based on cognitive structures that describe the features of prototypical or even actual patients.
Cognitive PsychologyRole of schemata in memory for places
836 Citations1981William F. Brewer, James C. Treyens
Artificial IntelligenceThe epistemology of a rule-based expert system —a framework for explanation
696 Citations1983William J. Clancey
This paper examines MYCIN''s rujles from the perspective of a teacher trying to justify them and to convey a problem-solving approach, and discovers that individual rules play different roles, have different kinds of justifications, and are constructed using different rationales for the ordering and choice of premise clauses.
Accretion, Tuning and Restructuring: Three Modes of Learning
573 Citations1976David E. Rumelhart, Donald A. Norman
This paper proposes three different mechanisms that seem to be responsible for the different phases of the learning of complex topic matters: accretion, restructuring, and tuning.
Cognitive ScienceOn the Role of Biomedical Knowledge in Clinical Reasoning by Experts, Intermediates and Novices
541 Citations1992Henny P. A. Boshuizen, Henk G. Schmidt
It was shown that experts have more in-depth biomedical knowledge than novices and subjects at intermediate levels of expertise and generally support a three-stage model of expertise development in medicine consisting of acquisition of biomedical knowledge, practical experience, and integration of theoretical and experientall knowledge resulting in knowledge encapsulation.
Journal of Verbal Learning and Verbal BehaviorText processing of domain-related information for individuals with high and low domain knowledge
520 Citations1979George J. Spilich, Gregg Vesonder +2 more
This paper presents the detailed propositional analyses of the text employed in a study that compared the contents of recall protocols of highAnowledde (HK) and by knowledge (LK1 groups) and the results are presented.
The American Journal of PsychologyProse Comprehension beyond the Word
513 Citations1982Richard C. Omanson, Arthur C. Graesser
Cognitive PsychologyKnowledge organization and skill differences in computer programmers
511 Citations1981Katherine B. McKeithen, Judith S. Reitman +2 more
This paper infer the details of individual programmers’ chunks of key programming concepts using the Reitman-Rtreter technique for inferring tree structures from recall orders.
Cognitive ScienceKnowledge based solution strategies in medical reasoning
504 Citations1986Vimla L. Patel, Guy J. Groen
Elsevier eBooksSOME PRINCIPLES OF MEMORY SCHEMATA
465 Citations1975Daniel G. Bobrow, Donald A. Norman
This chapter discusses the nature of memory reference processes that can lead automatically, without particular effort, to the richness of the retrievals that it is believed to be a fundamental property of human memory.
Medical EducationScripts and clinical reasoning
439 Citations2007Bernard Charlin, Henny P. A. Boshuizen +2 more
Clinical encounter represents an amazing series of psychological events: perceiving the features of the situation; quickly accessing relevant hypotheses; checking for signs and symptoms that confirm or rule out competing hypotheses; and using related knowledge to guide appropriate investigations and treatment.
Academic MedicineScripts and Medical Diagnostic Knowledge
437 Citations2000Bernard Charlin, Jacques Tardif +1 more
The authors describe how scripts are used in diagnostic tasks, how the script concept fits within the clinical reasoning literature, how it contrasts with competing theories of clinical reasoning, how educators can help students build and refine scripts, and how scripts can be used to assess clinical competence.
Cognitive ScienceKnowledge Based Solution Strategies in Medical Reasoning
429 Citations1986Vimla L. Patel, Guy J. Groen
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.
Journal of Verbal Learning and Verbal BehaviorRecognition memory for typical and atypical actions in scripted activities: Tests of a script pointer + tag hypothesis
357 Citations1979Arthur C. Graesser, Sallie E. Gordon +1 more
The hypothesis predicts that memory discrimination is better for atypical actions in a passage than for typical script actions and there is no memory discrimination for very typical actions and suggested that discriminative accuracy is best explained by properties of a passage's representation rather than the amount of cognitive resources allocated at acquisition.
Teaching and Learning in MedicineThe Script Concordance Test: A Tool to Assess the Reflective Clinician
351 Citations2000Bernard Charlin, Louise Roy +3 more
The SC test is a simple and direct approach to testing organization and use of knowledge that has the strong advantage for a testing method of being relatively easy to construct and use and to be machine-scorable.
Prose Comprehension Beyond the Word
319 Citations1981Arthur C. Graesser
Elsevier eBooksTHE STRUCTURE OF EPISODES IN MEMORY
314 Citations1975Roger C. Schank
This chapter discusses that the process of understanding is, in large part, the assigning of new input conceptualizations to causal sequences and the inference of remembered conceptualizations that will allow for complete causal chains.
Health PsychologyCommon sense representations of common illnesses.
305 Citations1983Richard R. Lau, Karen Hartman
Evidence is provided that common sense representations of common illnesses involve five components: (1) a label; (2) consequences; (3) a time line; (4) a cause; and (5) a cure.
Journal of Memory and LanguageThe representation of scripts in memory
285 Citations1985Valerie Abbott, John B. Black +1 more
Annals of Internal MedicineMedical Problem Solving.
232 Citations1978Arthur S. Elstein, L S Shulman +1 more
Problem Solving and Cognitive Skill Acquisition
200 Citations1988Kurt VanLehn
Archives of DermatologyThe Development of Expertise in Dermatology
176 Citations1989Geoff Norman
Accuracy of diagnosis and response times of subjects at five levels of expertise were assessed, showing that errors do not result predominantly from carelessness or speed, and that expertise is equated with a rapid "pattern-recognition" process.
Memory & CognitionMemory for actions in scripted activities as a function of typicality, retention interval, and retrieval task
171 Citations1981Donald A. Smith, Arthur C. Graesser
The retention function for conceptually driven retrieval is steeper for atypical than for typical actions, which supports the notion that the schema plays a more important role in guiding this type of retrieval as the retention interval increases.
Medical EducationScript concordance testing: a review of published validity evidence
170 Citations2011Stuart Lubarsky, Bernard Charlin +3 more
Journal of Experimental Psychology Learning Memory and CognitionSchema acquisition from a single example.
132 Citations1992Woo-kyoung Ahn, William F. Brewer +1 more
Journal of Memory and LanguageContrasting the representation of scripts and categories
127 Citations1985Lawrence W. Barsalou, Daniel R Sewell
Medical EducationContextual factors in the activation of first diagnostic hypotheses: expert‐novice differences
118 Citations1987P. P. M. HOBU, Henk G. Schmidt +2 more
It was hypothesized that differences in the number of correct diagnoses would emerge between the two groups, because the experts would use the contextual information, implicitly provided by picture and patient chart, in a more extensive way, and this would show in the amount of information that is explicitly recalled later.
Health PsychologyIllness representations: A prototype approach.
113 Citations1986George D. Bishop, Sharolyn A. Converse
Results of both experiments support the prototype hypothesis that information about physical symptoms is organized and processed according to people's preexisting beliefs about the association between particular symptoms and diseases.
Journal of Experimental Psychology Learning Memory and CognitionRecall by expert medical practitioners and novices as a record of processing attention.
95 Citations1989Geoffrey R. Norman, Lee R. Brooks +1 more
The results suggest that expert processing in this "discrete, independent inputs" domain requires effortful analysis with minimal reliance on default values, rather than relatively effortless pattern perception reported in highly visual areas of expertise.
Memory & CognitionThe influence of medical expertise, case typicality, and illness script component on case processing and disease probability estimates
93 Citations1996Eugène J. F. M. Custers, Henny P. A. Boshuizen +1 more
The data supported the predictions concerning the effects of expertise level and typicality; it was found that expert physicians are particularly sensitive to a combination of prototypical enabling conditions and prototypical consequences.
Journal of Memory and LanguageRetrieval of scripted concepts
93 Citations1986Frank R. Yekovich, Carol Walker
Academic MedicineProcessing of critical information by physicians and medical students
85 Citations1987Lorry Coughlin, Vimla L. Patel
The results show that the physicians recalled significantly more critical cues than the medical students, and this difference is due to the fact that the Physicians recognize patterns of familiar problems with respect to critical cues but the students do not.
Elsevier eBooksCONCEPTS FOR REPRESENTING MUNDANE REALITY IN PLANS
81 Citations1975Robert P. Abelson
This chapter discusses the scripts, because theory requires a good foundation at the script level, and low-level primitives such as GRASP are not the most useful components in the cognition of plans.
Cognition and InstructionThe Role of Illness Scripts in the Development of Medical Diagnostic Expertise: Results From an Interview Study
78 Citations1998Eugène J. F. M. Custers, Henny P. A. Boshuizen +1 more
It was found that participants at intermediate levels of expertise mentioned many enabling conditions when asked to describe a prototypical patient with a disease, whereas the instruction to describe the clinical picture of a disease revealed a monotonic relation with expertise level.
Applied Cognitive PsychologyCognitive psychology and medical diagnosis
73 Citations1990K. J. Gilhooly
Two major departures from the typical findings in other areas of expertise are found, viz. that memory for new information seems best at intermediate levels of skill rather than at high levels, and that a mixture of forward and backward reasoning (hypothetico-deductive inference) is common at all levels ofskill in medical diagnosis.
Journal of Experimental Social PsychologyThe role of expertise in processing social interaction scripts
72 Citations1985John B. Pryor, Thomas V. Merluzzi
Journal of Verbal Learning and Verbal BehaviorScript-based inferences: Effects of text and knowledge variables on recognition memory
62 Citations1984Carol Walker, Frank R. Yekovich
Memory & CognitionScript processing in a natural situation
60 Citations1985Glenn V. Nakamura, Arthur C. Graesser +2 more
An experiment is reported that shows that a schema-based model developed under laboratory conditions is generalizable to a natural situation by showing that irrelevant actions were remembered better than relevant actions.
Basic and Applied Social PsychologyProcessing Illness Information: The Role of Disease Prototypes
49 Citations1987George D. Bishop, Carole Briede +3 more
Teaching and Learning in MedicineThe Cognitive Validity of the Script Concordance Test: A Processing Time Study
47 Citations2005Robert Gagnon, Bernard Charlin +5 more
It is possible to predict what kind of information will be processed faster depending of the typicality and compatibility of clinical data for given hypotheses, and results support SCT construct validity.
Bulletin of the Psychonomic SocietyThe representational and processing characteristics of scripts
38 Citations1981Francis S. Bellezza, Gordon H. Bower
It was concluded that memory schemata may affect the storage of information both by providing an ideational scaffolding for new information relevant to the schema and by influencing the degree of processing that relevant vs. nonrelevant information receives.
Journal of Memory and LanguageRecognition and Recall of Irrelevant and Interruptive Atypical Actions in Script-Based Stories
36 Citations1994Denise Davidson
PubMedWhen less is more: representation and selective memory in expert problem solving.
34 Citations1993Frank Hassebrock, Paul Johnson +3 more
Journal of Experimental Psychology AppliedInfluence of Illness Script Components and Medical Practice on Medical Decision Making.
30 Citations2005Paul van Schaik, Darren Flynn +3 more
Both enabling conditions and consequences were found to be moderated by physician factors to a larger extent than previously assumed by illness script theory.
Memory & CognitionMemory for script actions: Effects of relevance and detail expectancy
30 Citations1990Ruth H. Maki
The results were interpreted as showing that both the relevance and the expectancy of the details in script actions are important in memory, but that the two dimensions may play different roles.
British Journal of PsychologyMemory for scripts with organized vs. randomized presentations
27 Citations1980Gordon H. Bower, Gail M. Clark-Meyers
Psychology Health & MedicineCollege students' knowledge of concepts related to the metabolic syndrome
26 Citations2008Bettina-Maria Becker, Rainer Bromme +1 more
Analysis of lay knowledge's structure suggests that a “lay kind of illness script” is a useful conceptualization of lay illness knowledge, and implications for doctor–patient communication are discussed.
Journal of Verbal Learning and Verbal BehaviorThe effect of input direction on the processing of script statements
24 Citations1984Karl Haberlandt, Geoffrey P. Bingham
Journal of Clinical InvestigationEvery patient tells a story
20 Citations2010Daniel W. Foster
As one active clinically in a large public hospital for which individuals of low socioeconomic status account for a significant proportion of admissions and in an academic hospital, my experience is that the mystery of disease and difficulty of diagnosis are not as ubiquitous as this book suggests.
Bulletin of the Psychonomic SocietyMemory for script-typical and script-atypical actions: A reaction time study
18 Citations1985Glenn V. Nakamura, Arthur C. Graesser
Journal of Continuing Education in the Health ProfessionsAssessing Patient Management Plans of Doctors and Medical Students: An Illness Script Perspective
13 Citations2012Alireza Monajemi, Henk G. Schmidt +1 more
The role of Mx knowledge in illness script development and how it relates to diagnostic knowledge in the course of development toward expertise is shown and experienced physicians' accurate management plans are characterized by a high number of the Mx and Dx items.
Journal of Thoracic OncologySpontaneous Smoking Cessation Before Lung Cancer Diagnosis
10 Citations2011Barbara G. Campling, Bradley N. Collins +3 more
These results challenge the notion that patients with lung cancer usually quit smoking because of disease symptoms, and suggest that spontaneous smoking cessation may be a presenting symptom of lung cancer.