Teaching Clinical Reasoning

Teaching Clinical Reasoning

Chapter topics include: Clinical Reasoning and Diagnostic Error Theoretical Concepts to Consider in Providing Clinical Reasoning Instruction Developing a Curriculum in Clinical Reasoning Educational Approaches to Common Cognitive Errors ...

Author: Robert L. Trowbridge

Publisher: American College

ISBN: 1938921054

Category: Clinical medicine

Page: 270

View: 590

Chapter topics include: Clinical Reasoning and Diagnostic Error Theoretical Concepts to Consider in Providing Clinical Reasoning Instruction Developing a Curriculum in Clinical Reasoning Educational Approaches to Common Cognitive Errors General Teaching Techniques Assessment of Clinical Reasoning Faculty Development and Dissemination Lifelong Learning in Clinical Reasoning Remediation of Clinical Reasoning Novel Approaches and Future Directions Teaching Clinical Reasoning: Where do we go from here?
Categories: Clinical medicine

Clinical Reasoning

Clinical Reasoning

This unique book provides a series of authentic, engaging and meaningful scenarios that will guide you through the clinical reasoning process while challenging you to think critically and creatively about the nursing care you provide.

Author: Tracy Levett-Jones

Publisher:

ISBN: 1442556625

Category: Medical logic

Page: 294

View: 491

A nurse's clinical reasoning ability is a key factor in the provision of quality care and the prevention of adverse patient outcomes. This unique book provides a series of authentic, engaging and meaningful scenarios that will guide you through the clinical reasoning process while challenging you to think critically and creatively about the nursing care you provide. It will promote deep learning and opportunities for you to rehearse how you will respond to real clinical situations in ways that are both person-centred and clinically astute.
Categories: Medical logic

Clinical Reasoning in the Health Professions E Book

Clinical Reasoning in the Health Professions E Book

Clinical reasoning lies at the core of health care practice and education.

Author: Joy Higgs

Publisher: Elsevier Health Sciences

ISBN: 9780702065057

Category: Medical

Page: 532

View: 388

Clinical reasoning lies at the core of health care practice and education. Clinical Reasoning in the Health Professions, therefore, occupies a central place in the education of health professionals, the enhancement of professional decision making of individuals and groups of practitioners with their clients, and research into optimal practice reasoning. All chapters updated and 20 new chapters added Concrete examples, cases and vignettes were added to bring discussions to life for the reader Reflection points strategically placed to assist readers to extend their insights and build learning from their own practical experiences and theoretical knowledge Devices of particular value to reflective practitioners and educators All chapters updated and 20 new chapters added Concrete examples, cases and vignettes were added to bring discussions to life for the reader Reflection points strategically placed to assist readers to extend their insights and build learning from their own practical experiences and theoretical knowledge Devices of particular value to reflective practitioners and educators.
Categories: Medical

Principles and Practice of Case based Clinical Reasoning Education

Principles and Practice of Case based Clinical Reasoning Education

This book is open access under a CC BY 4.0 license.

Author: Olle ten Cate

Publisher: Springer

ISBN: 9783319648286

Category: Education

Page: 207

View: 965

This book is open access under a CC BY 4.0 license. This volume describes and explains the educational method of Case-Based Clinical Reasoning (CBCR) used successfully in medical schools to prepare students to think like doctors before they enter the clinical arena and become engaged in patient care. Although this approach poses the paradoxical problem of a lack of clinical experience that is so essential for building proficiency in clinical reasoning, CBCR is built on the premise that solving clinical problems involves the ability to reason about disease processes. This requires knowledge of anatomy and the working and pathology of organ systems, as well as the ability to regard patient problems as patterns and compare them with instances of illness scripts of patients the clinician has seen in the past and stored in memory. CBCR stimulates the development of early, rudimentary illness scripts through elaboration and systematic discussion of the courses of action from the initial presentation of the patient to the final steps of clinical management. The book combines general backgrounds of clinical reasoning education and assessment with a detailed elaboration of the CBCR method for application in any medical curriculum, either as a mandatory or as an elective course. It consists of three parts: a general introduction to clinical reasoning education, application of the CBCR method, and cases that can used by educators to try out this method.
Categories: Education

ABC of Clinical Reasoning

ABC of Clinical Reasoning

This is important because studies suggest that diagnostic error is common and results in significant harm to patients – and errors in reasoning account for the majority of diagnostic errors.

Author: Nicola Cooper

Publisher: John Wiley & Sons

ISBN: 9781119059103

Category: Medical

Page: 64

View: 264

Being a good clinician is not just about knowledge – how doctors and other healthcare professionals think, reason and make decisions is arguably their most critical skill. While medical schools and postgraduate training programmes teach and assess the knowledge and skills required to practice as a doctor, few offer comprehensive training in clinical reasoning or decision making. This is important because studies suggest that diagnostic error is common and results in significant harm to patients – and errors in reasoning account for the majority of diagnostic errors. The ABC of Clinical Reasoning covers core elements of the thinking and decision making associated with clinical practice – from what clinical reasoning is, what it involves and how to teach it. Informed by the latest advances in cognitive psychology, education and studies of expertise, the ABC covers: Evidence-based history and examination Use and interpretation of diagnostic tests How doctors think – models of clinical reasoning Cognitive and affective biases Metacognition and cognitive de-biasing strategies Patient-centred evidence based medicine Teaching clinical reasoning From an international team of authors, the ABC of Clinical Reasoning is essential reading for all students, medical professionals and other clinicians involved in diagnosis, in order to improve their decision-making skills and provide better patient care.
Categories: Medical

Teaching in the Hospital

Teaching in the Hospital

This book provides hospital-based educators with tools and techniques for: Establishing and communicating expectations and responsibilities Conducting rounds to ensure education complements patient care Enhancing learning by using ...

Author: Jeff Wiese

Publisher: ACP Press

ISBN: 9781934465448

Category: Education

Page: 325

View: 919

The complexity of hospitalized patients and the day-to-day issues that arise on inpatient services make teaching in the hospital as challenging as it is unique. Hospital-based medical educators (hospitalists and attending physicians) must be adaptable and teach a wide range of topics, all while administering effective patient care. Written by experts in the field, Teaching in the Hospital offers a unique perspective on the goals of inpatient teaching and practical advice for hospitalists and attendings who teach on the wards. This book provides hospital-based educators with tools and techniques for: Establishing and communicating expectations and responsibilities Conducting rounds to ensure education complements patient care Enhancing learning by using illustrations, analogies, mnemonics, and other "tricks of the trade" Coaching learners in the science of clinical reasoning, communication, time management, and interpersonal relations This unique book includes clinical problem-based "teaching scripts" illustrating the dialogues that can take place around 15 of the most frequently encountered inpatient clinical problems. A part of ACP's Teaching Medicine Series, this title is available individually or as a part of the complete six-book set.
Categories: Education

Critical Thinking and Clinical Reasoning in the Health Sciences

Critical Thinking and Clinical Reasoning in the Health Sciences

This anthology offers some answers by way of successful examples of favorite lessons which work when teaching for both thinking and content.

Author: Noreen C. Facione

Publisher:

ISBN: 1891557602

Category: Medical

Page: 285

View: 565

This anthology offers some answers by way of successful examples of favorite lessons which work when teaching for both thinking and content.
Categories: Medical

Clinical Reasoning in the Health Professions

Clinical Reasoning in the Health Professions

New for the second edition: * Completely updated and revised * Development of patient-centred focus in clinical reasoning * New in paperback * Nine new chapters and 20 new contributors * New topics including action and narrative dynamics of ...

Author: Joy Higgs

Publisher: Butterworth-Heinemann Medical

ISBN: 0750639075

Category: Medical

Page: 322

View: 640

New for the second edition: * Completely updated and revised * Development of patient-centred focus in clinical reasoning * New in paperback * Nine new chapters and 20 new contributors * New topics including action and narrative dynamics of clinical reasoning; patient-centred care and intercultural issues in clinical reasoning * New teaching-learning strategies (eg peer coaching, case-based learning) and learning contexts (eg intercultural clinical education, critical care nursing)
Categories: Medical

Clinical Reasoning Cases in Nursing E Book

Clinical Reasoning Cases in Nursing   E Book

The 7th edition features a new concept-based organization, an enhanced focus on interprofessional collaboration and QSEN, 20 all-new case studies, and updated content throughout to reflect the most current standards of clinical practice.

Author: Mariann M. Harding

Publisher: Elsevier Health Sciences

ISBN: 9780323525121

Category: Medical

Page: 688

View: 199

Hone your ability to make sound clinical nursing judgment via a conceptual approach to teaching and learning with Harding & Snyder’s Clinical Reasoning Cases in Nursing, 7th Edition. This time-tested case study approach is highly regarded for its clinically relevant and thought-provoking cases. With each adoption, you’ll be able to tap into 150 unique case studies covering all four clinical practice areas: medical-surgical, pediatric, OB/maternity, and psychiatric nursing, all newly organized to facilitate a conceptual approach to teaching and learning. Each case covers a common patient problem, drawn from actual clinical experiences and written by nurses who are clinical experts. Cases include integrated content on pharmacology, nutrition, and diagnostic/laboratory tests to encourage you to think critically about all aspects of patient care. The 7th edition features a new concept-based organization, an enhanced focus on interprofessional collaboration and QSEN, 20 all-new case studies, and updated content throughout to reflect the most current standards of clinical practice. Awarded second place in the 2019 AJN Book of the Year Awards in Medical-Surgical category. Comprehensive assortment of 150 case studies draws from actual clinical experiences in medical-surgical, pediatric, OB/maternity, and psychiatric clinical areas to help you think critically, prioritize, and deliver proactive nursing care. Critical thinking approach helps you learn to identify changes, anticipate possible complications, and initiate therapeutic interventions. Progressive case complexity builds on previous learning to help you gradually develop more and more expertise. NEW & UNIQUE! Concept-based organization mirrors the growing use of concept-based curricula and conceptual approaches to teaching and learning in nursing education. NEW! 20 all-new cases and four extensively-revised cases that address important contemporary healthcare issues and allow for better coordination with Giddens, HESI, and other exemplar lists. NEW! Updated content throughout reflects the latest evidence-based clinical practice, including national and international treatment guidelines. NEW! Enhanced focus on interprofessional collaboration identifies opportunities for interprofessional collaboration are discussed. NEW! Greater consistency with the NCLEX Exam includes revisions like the elimination of most drug trade names and the inclusion of Canadian lab values. Enhanced QSEN safety emphasis is highlighted with a "target" icon to communicate "caution" or "safety." NEW! Increased emphasis on sepsis and antibiotic resistance throughout that addresses the growing problem of sepsis (a new Joint Commission "core measure") and antibiotic resistance where appropriate throughout. NEW! Improved answer spacing ensures that space left for answers reflects what is actually needed.
Categories: Medical

TRANSFORMING Classroom and Clinical Teaching

TRANSFORMING Classroom and Clinical Teaching

Numerous practical strategies and tools to strengthen clinical reasoning and the ability of students to think more like a nurse in both the classroom and clinical settings.

Author: Pence

Publisher:

ISBN: 0989936988

Category:

Page:

View: 361

Numerous practical strategies and tools to strengthen clinical reasoning and the ability of students to think more like a nurse in both the classroom and clinical settings.
Categories:

Clinical and Professional Reasoning in Occupational Therapy

Clinical and Professional Reasoning in Occupational Therapy

Each chapter includes learning objectives and a key word list. Photographs, figures, and tables support reader understanding.

Author: Barbara A. Boyt Schell

Publisher: Lippincott Williams & Wilkins

ISBN: 0781759145

Category: Medical

Page: 462

View: 546

This comprehensive textbook lets readers develop the strong theoretical and practical foundation needed for effective decision-making in occupational therapy. Emphasis on both clinical and professional reasoning gives readers the skills needed to make informed decisions as practitioners, managers, and educators. This textbook offers easy-to-follow explanations of current theories of clinical and professional reasoning, demonstrating their relevance to occupational therapy work. "Thinking about Thinking" quotes offer thought-provoking perspectives on reasoning. Case examples and learning activities demonstrate how reasoning is applied in various clinical and professional scenarios. Each chapter includes learning objectives and a key word list. Photographs, figures, and tables support reader understanding.
Categories: Medical

The Essentials of Clinical Reasoning for Nurses Using the Outcome Present State Test Model for Reflective Practice

The Essentials of Clinical Reasoning for Nurses  Using the Outcome Present State Test Model for Reflective Practice

In The Essentials of Clinical Reasoning for Nurses, authors RuthAnne Kuiper, Sandra O’Donnell, Daniel Pesut, and Stephanie Turrise provide a model that supports learning and teaching clinical reasoning, development of reflective and ...

Author: RuthAnne Kuiper

Publisher: Sigma Theta Tau

ISBN: 9781945157097

Category: Medical

Page: 464

View: 792

In today’s healthcare environment of scarce resources and challenges related to safety and quality, nurses must make decision after decision to ensure timely, accurate, and efficient provision of care. Solid decision-making, or lack thereof, can significantly affect patient care and outcomes. Clinical reasoning – how a nurse processes information and chooses what action to take – is a skill vital to nursing practice and split-second decisions. And yet, developing the clinical reasoning to make good decisions takes time, education, experience, patience, and reflection. Along the way, nurses can benefit from a successful, practical model that demystifies and advances clinical reasoning skills. In The Essentials of Clinical Reasoning for Nurses, authors RuthAnne Kuiper, Sandra O’Donnell, Daniel Pesut, and Stephanie Turrise provide a model that supports learning and teaching clinical reasoning, development of reflective and complex thinking, clinical supervision, and care planning through scenarios, diagnostic cues, case webs, and more.
Categories: Medical

Clinical Education in the Health Professions

Clinical Education in the Health Professions

This book draws on the research, ideas and expertise of researchers who have observed and researched different aspects of clinical education.

Author: Clare Delany

Publisher: Elsevier Australia

ISBN: 9780729539005

Category: Medical

Page: 193

View: 637

Clinical settings are dynamic educational spaces that present both opportunities and barriers to learning and teaching. Designed to inform, challenge and educate health professionals about the evidence underpinning clinical education practices and outcomes, this multi-disciplinary book brings together important concepts in healthcare education and addresses context and processes of learning, professional identity and socialisation, feedback and assessment, ethics, and inter-professional education. The authors encourage teaching and learning practices based on research findings, expertise and innovation, and the development of individual teaching methods and styles from a theoretical base that provides relevant principles, direction and support. With clear links between theory, research and practice, collaboration from a broad range of clinical disciplines, and models for learning and teaching grounded in empirical research, Clinical Education in the Health Professions will become a standard reference for all health professionals and educators. examines patterns of practice in clinical education in the health professions, using a qualitative research focus identifies the roles of university and clinical educators, students, peers and patients in clinical education highlights implicit tensions in clinical education practice and presents strategies to identify and address such tensions challenges the reader to consider new approaches to clinical education that may optimise students' learning and enculturation into the health professions Despite claims that clinical education lies at the heart of health care education, little empirical research has explored what constitutes effectiveness in clinical teaching and learning. This book draws on the research, ideas and expertise of researchers who have observed and researched different aspects of clinical education. Their research has spanned clinical education topics including professional identity and socialisation, assessment and feedback, pedagogical methods, clinical reasoning, dealing with ambiguity, dealing with diversity and interprofessional education. This book has been designed to synthesise empirical clinical education research and ideas about the context, value, processes and outcomes of clinical education. Each chapter presents a research based facet of clinical education as a platform from which knowledge and future research in clinical education can occur. The authors entice the reader to reconceptualise facets of their own teaching and learning practices based on research findings, expertise and innovation.
Categories: Medical

Clinical Reasoning and Decision Making in Physical Therapy

Clinical Reasoning and Decision Making in Physical Therapy

The text centers on life-long learning by encouraging the development of clinical reasoning abilities from professional education through residency education.

Author: Gina Maria Musolino

Publisher: Slack

ISBN: 1630914088

Category: Medical

Page: 375

View: 717

Clinical reasoning is an essential non-negotiable element for all health professionals. The ability of the health professional to demonstrate professional competence, compassion, and accountability depend on a foundation of sound clinical reasoning. The clinical reasoning process needs to bring together knowledge, experience, and understanding of people, the environment, and organizations along with a strong moral compass in making sound decisions and taking necessary actions. While clinical reasoning and the role of mentors has been a focus of the continued growth and development of residency programs in physical therapy, there is a critical need to have a broader, in-depth look at how educators across academic and clinical settings intentionally facilitate the development of clinical reasoning skills across one's career. Clinical Reasoning and Decision Making in Physical Therapy: Facilitation, Assessment, and Implementation fills this need by providing a comprehensive and in-depth focus on development of the patient-client management skills of clinical reasoning and clinical decision-making. It takes into account teaching and learning strategies, assessment, and technological applications across the continuum from novice to residents/fellows-in-training, along with academic and clinical faculty for both entry-level and specialist practice. Drs. Gina Maria Musolino and Gail Jensen have designed this comprehensive resource with contributions from professional colleagues. The text centers on life-long learning by encouraging the development of clinical reasoning abilities from professional education through residency education. The aim and scope of the text is directed for physical therapy education, to enhance clinical reasoning and clinical decision-making for developing professionals and post-professionals in both clinical and academic realms, and for the development of clinical and academic faculty. Clinical Reasoning and Decision Making in Physical Therapy uniquely offers both evidence-based approaches and pragmatic consultation from award-winning authors with direct practice experiences developing and implementing clinical reasoning/clinical decision-making in practice applications for teaching students, residents, patients, and clinical/academic faculty in classrooms, clinics, and through simulation and telehealth. Clinical Reasoning and Decision Making in Physical Therapy is the first of its kind to address this foundational element for practice that is key for real-world practice and continuing competence as a health care professional. Physical therapy and physical therapist assistant students, faculty, and clinicians will find this to be an invaluable resource to enhance their clinical reasoning and decision making abilities.
Categories: Medical

Handbook of Teaching for Physical Therapists E Book

Handbook of Teaching for Physical Therapists   E Book

184 What Can We Learn from the Clinical Reasoning of Expert Physical
Therapists that can Inform Our Teaching? 184 Clinical Reasoning Strategies
Model 185 Student Physical Therapists' Understanding of Clinical Reasoning
188 Role of ...

Author: Gail M. Jensen

Publisher: Elsevier Health Sciences

ISBN: 9781455706013

Category: Medical

Page: 304

View: 815

Whether you are practicing in an in-patient or an out-patient facility, academic institution, or clinical residency program, this well-respected handbook gives you the background and guidance you need to effectively educate individuals across the continuum of physical therapy practice. Practical, real-life examples show you how to: incorporate health literacy and needs of the learner; assess and adapt to the various learning styles of patients; use simulations in education; facilitate the development of clinical reasoning skills; and assess learning outcomes and the effectiveness of your teaching. Plus, four all-new chapters and major revisions of all content throughout the book keep you on top of the latest research and best practices. Coverage of the theory and application of educational principles across the continuum of PT practice provides the information you need to improve your skills in the educational process both in academic and clinical settings. Two section format divides content into two parts: designing academic and clinical education programs and teaching students in academic and clinical settings; and teaching patients and families in clinical and community settings. Variety of teaching and teaching assessment methods expands your teaching, learning, and assessment repertoires. Case stories at the beginning of each chapter allow you to see the relevance of the information in the chapter. Threshold concepts highlight key ideas that are important to know. Annotated bibliography at end of each chapter provides resources for further study. NEW! Chapter on Authentic Assessment: Simulation-Based Education reflects the new ways to facilitate student learning through the use of human simulation models. NEW! Chapter on Strategies for Planning and Implementing Interprofessional Education covers the fundamental concepts of team-based care and interprofessional learning. NEW! Chapter on What Makes a Good Clinical Teacher? translates current research on clinical teaching into clinical education and practice. NEW! Chapter on Facilitating the Teaching and Learning of Clinical Reasoning helps you apply current research on clinical reasoning in rehabilitation to clinical education and teaching. NEW! Two combined chapters on Patient Education and Health Literacy (previously chapters 8 and 12) and Applied Behavioral Theory and Adherence: Models for Practice (previously chapters 9 and 10) provide focused presentations on current thinking and practical strategies for addressing health literacy issues in the clinical environment. NEW! Expanded chapter on Post-Professional Clinical Residency and Fellowship Education offers more information on models and trends in residency education and mentoring.
Categories: Medical

Teaching Professional Attitudes and Basic Clinical Skills to Medical Students

Teaching Professional Attitudes and Basic Clinical Skills to Medical Students

This concise, easy to read title is designed for clinical teachers looking to refine their approach to teaching professional attitudes and basic skills to medical students.

Author: Jochanan Benbassat

Publisher: Springer

ISBN: 9783319200897

Category: Medical

Page: 143

View: 693

This concise, easy to read title is designed for clinical teachers looking to refine their approach to teaching professional attitudes and basic skills to medical students. Doctors differ in values, training and practice setting, and eventually they adopt diverse approaches to patient interviewing, data collection and problem-solving. As a result, medical students may encounter significant differences in the clinical methods of their tutors. For example, some doctors encourage patients’ narratives by using open-ended questions while others favor closed-questions; and hospital- and community-based doctors may disagree on the value of the physical examination. Medical students may be puzzled by these differences and by controversies about issues, such as doctor-patient relations and the approaches to clinical reasoning. This handy title is intended to help tutors address many of these issues, and to provide an approach not only to teaching patient interviewing and the physical examination but to teaching some clinically relevant topics of the behavioral and social sciences that are so vital to developing an effective, well-rounded physician.
Categories: Medical

Residents Teaching Skills

Residents        Teaching Skills

How, then, do clinical teachers teach medical problem-solving or the clinical
reasoning process? The teaching of all procedural skills, including the clinical
reasoning process, involves demonstrating the process and then providing
practice ...

Author: Janine C. Edward, PhD

Publisher: Springer Publishing Company

ISBN: 0826115691

Category: Medical

Page: 280

View: 266

"The editors have collected an impressive array of practical material that will guide any academic medical center in the development of a more focused approach to "teaching the teachers." From learning theory and program development to teaching performance evaluation and specialty-specific materials, Residents' Teaching Skills covers all the bases. I commend this volume to the attention of medical educators everywhere, and residency program directors in particular." --from the Foreword by Jordon J. Cohen, MD, President, Association of American Medical Colleges This book provides practical guidance to plan, organize, and run a teaching skills program for medical residents. Readers will find that Part Two offers exact materials for course use, including modules for use with pediatric residents, teaching clinical procedures, works rounds, and role play, plus evaluation forms that can be used as written or customized to fit a particular program.
Categories: Medical

Clinical Reasoning in Small Animal Practice

Clinical Reasoning in Small Animal Practice

By guiding you to think pathophysiologically, this book will help solve clinical problems as efficiently as possible.

Author: Jill E. Maddison

Publisher: John Wiley & Sons

ISBN: 9781118741733

Category: Medical

Page: 280

View: 163

Clinical Reasoning in Small Animal Practice presents a revolutionary approach to solving clinical problems. As a veterinarian, especially as a student or new graduate, a ten minute consultation in a busy small animal practice can be a daunting task. By guiding you to think pathophysiologically, this book will help solve clinical problems as efficiently as possible. The authors set out a structured approach with easy to remember rules which can be applied to most clinical signs small animals present with. This reduces the need to remember long lists of differentials and avoids the potential of getting trapped by a perceived obvious diagnosis. The book will help to unlock your potential to solve clinical problems. It also provides a logical rationale for choosing diagnostic tests or treatments which can be clearly communicated to the owner. Written by internationally renowned clinicians and educators in clinical reasoning, key features of the book include: An easy to remember and logical approach to solving a wide range of clinical problems encountered in small animal medicine and neurology An invaluable resource for every level of learner, from student to experienced practitioner Flowcharts and key step markers throughout help illustrate the decision making process Clinical inductive reasoning offers you the ability to solve cases more efficiently, resulting in better treatment and care for pets and happier owners. Clinical Reasoning in Small Animal Practice will help turn a terrifying case into a manageable one!
Categories: Medical

Problem Based Learning

Problem Based Learning

This book presents the scientific basis of problem-based learning and goes on to describe the approaches to problem-based medical learning that have been developed over the years at McMaster University, largely by Barrows and Tamblyn.

Author: Howard S. Barrows, MD

Publisher: Springer Publishing Company

ISBN: 0826128424

Category: Medical

Page: 224

View: 961

In this book, the authors address some basic problems in the learning of biomedical science, medicine, and the other health sciences. Students in most medical schools, especially in basic science courses, are required to memorize a large number of "facts," facts which may or may not be relevant to medical practice. Problem-based learning has two fundamental postulates--the learning through problem-solving is much more effective for creating a body of knowledge usable in the future, and that physician skills most important for patients are problem-solving skills, rather than memory skills. This book presents the scientific basis of problem-based learning and goes on to describe the approaches to problem-based medical learning that have been developed over the years at McMaster University, largely by Barrows and Tamblyn.
Categories: Medical