Intelligent Tutoring Systems for Ill-Defined Domains - Philippe ...

77 Gauthier, Naismith, Lajoie, & Wiseman
4.3 Comparison with Expert Solutions
The case questionnaires were completed after the students solved the case and
interacted with the available feedback. In general, the students did not provide very
elaborate responses to the questions posed in this questionnaire. For example, in
Case 1, S16 (control) provides a cursory response to the question Can you compare
your answer and your reasoning process to the one given by the expert?: “The
expert’s reasoning process is helpful as a way to reflect on the errors in my own
reasoning process, in particular pertaining to the correct tests to order.”
A preliminary comparison between the responses of the two groups suggested that
the experimental group was more aware of diagnosis as a process rather than just an
outcome. For example, the following responses were given to the same question
posed above:
I kept thinking that it was the drug itself causing all the vascular
problems, and didn’t recognize the problem of a 37 year old
woman actually having high blood pressure that required
treatment in the first place. So I arrived at a drug induced
arrhythmia which could have explained her symptoms, but it
would definitely be more likely in an older patient with more risk
factors for essential hypertension. I have to pay more attention to
the baseline evidence of the patient rather than just focusing on
the most recent data. (S11)
I had the same initial hypothesis as the expert (Graves’ disease)
which following normal TSH, T3 and T4 levels I changed for
pheochromocytoma. However, when I went to the [BioWorld]
library to find more information about the condition, there was
none to be found…As I knew that these tumours produced
excess catecholamines, I scanned through the tests to find one
that would allow me to measure them – but I wasn’t sure what
exactly to order. When these tests came back negative, I also
considered the possibility of a heart arrhythmia, which was
supported by bundle branchblock in her ECG. I kept forgetting
to go back and readjust my hypothesis, in terms of %
probability. If I remember correctly, I also checked her
hemoglobin to make sure she wasn’t anaemic. (S3)
At least one student in the experimental group was able to recognize how her
approach might be different than that of an expert: “I went directly to the diseases that
I was most familiar with, like hyperthyroidism and panic attacks. I think the expert
had more familiarity with a condition like pheochromocytoma and so it occurred to
him or her more immediately.” (S4, Case 1).